Bharathi Raja Rajaganapathy
Full Text Available Liposomes have been used therapeutically and as a local drug delivery system in the bladder. However, the exact mechanism for the uptake of liposomes by bladder cells is unclear. In the present study, we investigated the role of endocytosis in the uptake of liposomes by cultured human UROtsa cells of urothelium and rat bladder. UROtsa cells were incubated in serum-free media with liposomes containing colloidal gold particles for 2 h either at 37°C or at 4°C. Transmission Electron Microscopy (TEM images of cells incubated at 37°C found endocytic vesicles containing gold inside the cells. In contrast, only extracellular binding was noticed in cells incubated with liposomes at 4°C. Absence of liposome internalization at 4°C indicates the need of energy dependent endocytosis as the primary mechanism of entry of liposomes into the urothelium. Flow cytometry analysis revealed that the uptake of liposomes at 37°C occurs via clathrin mediated endocytosis. Based on these observations, we propose that clathrin mediated endocytosis is the main route of entry for liposomes into the urothelial layer of the bladder and the findings here support the usefulness of liposomes in intravesical drug delivery.
Considerable progress has been made over the past decade in the use of tumour-associated monoclonal antibodies (mAbs) as carriers of cytotoxic agents in the management of several malignancies. In the present study we investigated the tumour localization and biodistribution of the mAb HMFG1 to bladder cancer following intravesical administration, HMFG1, which has been raised against the polymorphic epithelial mucin (PEM), was labelled with 125I and administered intravesically 2 h and 24 h before cystoscopy. During cystoscopy, biopsies were taken from the normal bladder and the malignant lesion. Tissue samples were tested for HMFG1 immunostaining and for radioactivity with the use of a γ-counter. The mean ratio of tumour to normal uptake for 125I-HMFG1 was 5.81±1.23, at 2 h and 2.17±0.42 at 24 h. No radioactivity was detected in the blood. We conclude that HMFG1 could be used intravesically for the successful delivery of a cytotoxic agent. (orig.)
To evaluate the effects of intravesical administration of paclitaxel (PTX-30W), which was prepared by solubilization with a water-soluble amphiphilic polymer composed of PMB30W, a copolymer of 2-methacryloyloxyethyl phosphorylcholine and n-butyl methacrylate, in an orthotopic bladder cancer model. The cytotoxicities of PMB30W were examined in MBT-2 cell cultures and the results were compared with those of the conventional paclitaxel solubilizer Cremophor. In an orthotopic MBT-2 bladder cancer model, the effect of intravesical administration of PTX-30W was compared with that of paclitaxel solubilized with Cremophor (PTX-CrEL). The paclitaxel concentration in bladder tumors after the intravesical treatment was also evaluated using liquid chromatography tandem mass spectrometry (LC-MS/MS) system. In vitro, Cremophor exhibited dose-dependent cytotoxicity towards MBT-2 cells, whereas no cytotoxicity was observed with PMB30W. In the orthotopic bladder cancer model, intravesical administration of PTX-30W resulted in a significant reduction of bladder wet weight compared with that of PTX-CrEL. The paclitaxel concentration in bladder tumors after the intravesical treatment was significantly higher in PTX-30W treated mice than in PTX-CrEL treated mice. Intravesically administered PTX-30W can elicit stronger antitumor effects on bladder tumors than conventional paclitaxel formulated in Cremophor, presumably because of its better penetration into tumor cells. PTX-30W might be a promising antitumor agent for intravesical treatment of non-muscle invasive bladder cancer
Nogawa, Masaki; Yuasa, Takeshi; Kimura, Shinya; Tanaka, Motoyoshi; Kuroda, Junya; SATO, Kiyoshi; Yokota, Asumi; Segawa, Hidekazu; Toda, Yoshinobu; Kageyama, Susumu; YOSHIKI, Tatsuhiro; Okada, Yusaku; Maekawa, Taira
The mainstay in the management of invasive bladder cancer continues to be radical cystectomy. With regard to improvement of quality of life, however, therapies that preserve the bladder are desirable. We investigated the use of intravesical PLK-1 small interfering RNA (siRNA) against bladder cancer. Patients with bladder cancers expressing high levels of PLK-1 have a poor prognosis compared with patients with low expression. Using siRNA/cationic liposomes, the expression of endogenous PLK-1 c...
Full Text Available Cystitis glandularis (CG is a proliferative disorder in the urinary bladder. The outcome of current treatments in some patients is not satisfactory. Curcumin, a herbal medicine that has been used for centuries, has shown great potential in treating various diseases. Our pilot study aimed to explore the feasibility of an intravesical treatment for CG using curcumin. 14 patients diagnosed with CG that remained symptomatic after primary treatments were enrolled, underwent a 3-month curcumin intravesical treatment (50 mg/50 mL, 1 hour, once per week for first 4 weeks and once per month for next 2 months and were followed up for 3 months. Efficacy of the treatment was evaluated using core lower urinary tract symptom score (CLSS questionnaire. 10 patients demonstrated persistent improvement in symptoms up to the end of the 6-month study. Their CLSS decreased significantly after the 3-month treatment (6.0±0.8; P<0.01 from the baseline (10.5±1.6 and maintained decreasing till the end of the study (6.2±0.7; P<0.01. 4 patients were classified as nonresponders. Our study suggests the feasibility of further randomized controlled trials on curcumin intravesical treatment in CG patients who remain symptomatic after primary treatments.
Intravesical administration of combined hyaluronic acid (HA) and chondroitin sulfate (CS) for the treatment of female recurrent urinary tract infections: a European multicentre nested case–control study
Ciani, Oriana; Arendsen, Erik; Romancik, Martin; Lunik, Richard; Costantini, Elisabetta; Di Biase, Manuel; Morgia, Giuseppe; Fragalà, Eugenia; Roman, Tomaskin; Bernat, Marian; Guazzoni, Giorgio; Tarricone, Rosanna; Lazzeri, Massimo
Objectives To compare the clinical effectiveness of the intravesical administration of combined hyaluronic acid and chondroitin sulfate (HA+CS) versus current standard management in adult women with recurrent urinary tract infections (RUTIs). Setting A European Union-based multicentre, retrospective nested case–control study. Participants 276 adult women treated for RUTIs starting from 2009 to 2013. Interventions Patients treated with either intravesical administration of HA+CS or standard of care (antimicrobial/immunoactive prophylaxis/probiotics/cranberry). Primary and secondary outcome measures The primary outcome was occurrence of bacteriologically confirmed recurrence within 12 months. Secondary outcomes were time to recurrence, total number of recurrences, health-related quality of life and healthcare resource consumption. Crude and adjusted results for unbalanced characteristics are presented. Results 181 patients treated with HA+CS and 95 patients treated with standard of care from 7 centres were included. The crude and adjusted ORs (95% CI) for the primary end point were 0.77 (0.46 to 1.28) and 0.51 (0.27 to 0.96), respectively. However, no evidence of improvement in terms of total number of recurrences (incidence rate ratio (95% CI), 0.99 (0.69 to 1.43)) or time to first recurrence was seen (HR (95% CI), 0.99 (0.61 to 1.61)). The benefit of intravesical HA+CS therapy improves when the number of instillations is ≥5. Conclusions Our results show that bladder instillations of combined HA+CS reduce the risk of bacteriologically confirmed recurrences compared with the current standard management of RUTIs. Total incidence rates and hazard rates were instead non-significantly different between the 2 groups after adjusting for unbalanced factors. In contrast to what happens with antibiotic prophylaxis, the effectiveness of the HA+CS reinstatement therapy improves over time. Trial registration number NCT02016118. PMID:27033958
Sallami, Sataa; Nouira, Yassine; Kallel, Yousri; Gargouri, Mourad; Horchani, Ali
A case of intravesical hydatid cyst is reported. The cyst was completely evacuated cystoscopically with intravesical instillation of a scolicidal agent (hydrogen peroxide) to destroy scolices and daughter cysts. The postoperative course was uneventful, and follow-up did not show evidence of recurrence. Because this is the first case, to our knowledge, to be reported, little is known about the nonoperative management of such hydatid localization. A recommendation is made, however, to adopt this minimally invasive procedure. PMID:16286147
Westhovens, Ine M; Vanden Abeele, Marie-Elena; Messiaen, Peter E; van der Hilst, Jeroen Ch
BCG is an attenuated live strain of Mycobacterium bovis that is used as an intravesical immunotherapy for superficial bladder cancer. Although generally well tolerated, BCG instillation can lead to systemic diseases. We present a case of a 75-year-old man who was treated for recurrent localised transitional cell carcinoma (TCC) of the bladder with intravesical instillation of BCG in 2006. His medical history included Parkinson's disease. The patient reported worsening of Parkinson symptoms in the preceding month. In addition, he had progressive pancytopaenia and a bone marrow biopsy showed a granulomatous inflammatory infiltrate. Cultures from bone marrow aspiration grew M. bovis He was successfully treated with tuberculostatic drugs and made a full recovery. In addition, there was partial amelioration of the Parkinson symptoms. This case shows that physicians should be aware that BCG instillation for TCC can cause systemic disease even years after treatment. PMID:27170615
Janicki, Joseph J.; Gruber, Michele A.
Intravesical therapy has previously shown to be effective in delaying or preventing recurrence of superficial bladder cancer. This local route of drug administration is now demonstrating promise in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS) with the benefit of minimal systemic side effects. Liposomes (LPs) are lipid vesicles composed of phospholipid bilayers surrounding an aqueous core. They can incorporate drug molecules, both hydrophobic and hydrophilic, and vastly improve cellular uptake of these drug molecules via endocytosis. Intravesical LPs have therapeutic effects on IC/BPS patients, mainly due to their ability to form a protective lipid film on the urothelial surface and repair the damaged urothelium. This review considers the current status of intravesical LPs and LP mediated drug delivery for the treatment of IC/BPS. PMID:26816855
In clinical settings, intravesical instillation of a drug bolus is often performed for the treatment of bladder diseases. However, it requires repeated instillations to extend drug efficacy, which may result in poor patient compliance. To alleviate this challenge, implantable devices have been developed for the purpose of sustained, intravesical drug delivery. In this review, we briefly summarize the current trend in the development of intravesical drug-delivery devices. We also introduce the most recently developed devices with strong potential for intravesical drug-delivery applications. PMID:27377941
Moch, Céline; Salmon, Damien; Rodríguez Armesto, Laura; Colombel, Marc; Pivot, Christine; Pirot, Fabrice
The aims of this study were to assess the tissue permeability of the bladder and to characterize the transport of four drugs displaying different physico-chemical properties and commonly used in intravesical delivery, through porcine bladder. The transport of aluminium through porcine bladder was assessed by using a vertical static diffusion cell. Lidocaine hydrochloride, methylprednisolone hemisuccinate and mitomycin C were tested by using three different experimental setups, including vertical static diffusion cell, microdialyseur and lab-patented device. Penetration results on different experimental setups were homogenous suggesting dependency on physico-chemical characteristics of drug and subsequent interaction with bladder wall structure. Oppositely, permeation varied consistently with experimental setup characteristics (i.e., permeation surface, receptor fluid volume and hydrodynamic). Mathematical modelling of drug transport through bladder wall is proposed considering scarce literature on this route of administration. Practical outcome of this study could drive compounding optimization towards improvement of safety and efficacy in patient undergoing intravesical administration. PMID:24463072
Jeffrey J Tomaszewski
Full Text Available Jeffrey J Tomaszewski, Marc C SmaldoneDepartment of Urology, University of Pittsburgh School of Medicine, Pennsylvania, USAAbstract: Transitional cell carcinoma (TCC is the second most common urologic malignancy, and 70% of patients present with superficial or nonmuscle invasive bladder cancer (NMIBC. Intravesical bacillus Calmette-Guerin (BCG is the most effective agent for preventing disease recurrence, and the only therapy able to inhibit disease progression. However, recurrence rates as high as 30% and significant local and systemic toxicity have led to increased interest in alternative intravesical therapies. In patients refractory or intolerant to BCG, BCG-interferon α2b, gemcitabine, and anthracyclines (doxorubicin, epirubicin, valrubicin have demonstrated durable clinical responses. Phase I trials investigating alternative cytotoxic agents, such as apaziquone, taxanes (docetaxel, paclitaxel, and suramin are reporting promising data. Novel immunomodulating agents have demonstrated promise as efficacious alternatives in patients refractory to BCG. Optimization of existing chemotherapeutic regimens using hyperthermia, photodynamic therapy, magnetically-targeted carriers, and liposomes remains an area of active investigation. Despite enthusiasm for new intravesical agents, radical cystectomy remains the treatment of choice for patients with NMIBC who have failed intravesical therapy and selected patients with naïve T1 tumors and aggressive features. This report provides a comprehensive review of contemporary intravesical therapy for NMIBC and refractory NMIBC, with an emphasis on emerging agents and novel treatment modalities.Keywords: transitional cell carcinoma, nonmuscle, invasive, intravesical therapy, BCG
Marchalik, Daniel; Krishnan, Jayashree; Verghese, Mohan; Venkatesan, Krishnan
A 26-year-old woman with a complicated urological and gynecological history with uterine didelphys with bilaterally inserting intravesical cervical oses presented with cyclical haematuria. Work up revealed a mass in the ectopic cervical os and adjacent bladder wall. Subsequent resection confirmed a clear cell adenocarcinoma of urological origin with invasion into neighbouring os. PMID:26109625
Kirchgesner, T; Danse, E; Tombal, B
Hematuria is one of the most frequent minor complications after prostatic biopsy. We would like to report the case of a 68-year-old patient with massive hematuria after prostatic biopsy and intravesical active prostate bleeding diagnosed in B-mode ultrasonography. PMID:24034804
Full Text Available Intravesical instillation of Bacillus Calmette-Guerin (BCG is the treatment of choice for superficial bladder carcinoma. Disseminated BCG infection presenting as granulomatous hepatitis or pneumonitis is a very rare complication of this treatment. Here we report a case series of seven patients previously treated with BCG presenting with pneumonitis. In two of the cases, identification of Mycobacterium bovis was achieved with molecular methods.
ZHOU Jie; XIE Shusheng; GUO Xiaoyun; MO Zengnan
In order to study bladder intravesical instillation methods in pure line LEW rats and nude mice, female LEW rats and nude mice aged 2 to 4 weeks were sacrificed. Their urethra and bladder were observed under anatomical microscopy. A trochar was prepared according to the outline and angle of the urethra. Ink was poured into female rats and nude mice bladder though urethra. Filling and staining of bladder were observed and evaluated under anatomical microscopy. Status and urethral injury of rats and mice were observed. The results showed that urethra anatomic structure of rats and nude mice was different from that of human urethra. When bladder was filled with ink and became blue, liquid was not seen to leak out. The success rate of intubation was high (100%). Living activities of animals weren't influenced by intravesical instillation. It was concluded that bladder irrigation might be a kind of valid and utilizable method in pure line rat and nude mouse empirical study. The model may be a more effective tool for study of bladder tumor.
Rosati, Yuri; Fabiani, Andrea; Taccari, Tommaso; Ranaldi, Renzo; Mammana, Gabriele; Tubaldi, Alberto
Immunotherapy with intravesical bacillus Calmette-Guérin (BCG) is considered the most effective adjuvant to endoscopic resection of bladder urothelial carcinoma in the therapeutic management of non-muscle invasive (NMIBC) at intermediate and high risk of recurrence and progression (pTa - pT1 and high-grade carcinoma in situ, CIS). Despite its proven efficacy, this type of treatment can determine local and systemic side effects of moderate or severe gravity, with the histological diagnosis of epithelioid granulomas in different organs, even in the absence of microbiological positivity of BCG. The immunotherapy with BCG is usually well tolerated and the virulence of the attenuated BCG is very low in immuno-competent patients, although only 16% of patients are able to receive all the instillations of the maintenance period (3 years) of treatment provided by the protocols, precisely because of side effects. Minor side effects usually resolve within a few hours or days. They develop in 3-5% of patients and usually consist of local infectious complications. Manifestations of BCG dissemination, such as vascular and ocular complications, are much less common, while BCG-disseminated infections, with granulomatous pneumonia or hepatitis present, are quite rare, representing 0.5-2% of the complications recorded. We present the clinical case of granulomatous lung and possibly liver infection caused by BCG in a patient aged 56 years being treated for several weeks with intravesical BCG for NIMBC pT1 high grade associated with CIS. PMID:26616461
Wei Xia Ang; Ying Zhao; Timothy Kwang; Chunxiao Wu; Can Chen; Han Chong Toh; Ratha Mahendran; Kesavan Esuvaranathan; Shu Wang
Intravesical instillation of Bacillus Calmette-Guérin is currently used as adjuvant therapy for superficial, non-muscle invasive bladder cancer (NMIBC). However, nearly 40% of patients with NMIBC will fail Bacillus Calmette-Guérin therapy. In an attempt to investigate the feasibility of using insect baculovirus-based vectors for bladder cancer therapy, we observed that intravesical instillation of baculoviruses without transgene up-regulated a set of Th1-type of cytokines and increased the su...
Full Text Available Intravesical instillation of Bacillus Calmette-Guerin (BCG is a treatment to prevent recurrence of superficial urothelial bladder carcinoma. Complications after bladder instillation of BCG have been reported including locally invasive and systemic infections due to dissemination of Mycobacterium bovis from the bladder. We present an uncommon case and literature review of prosthetic joint infection due to M. bovis after intravesical BCG treatment of bladder cancer.
Puri, P; O'Donnell, B
Vesicoureteric reflux was produced in eight piglets by opening their bladders and slitting the anterior intravesical wall of the ureter. Cystography confirmed the presence of bilateral reflux in six piglets and unilateral reflux in two. Six to eight weeks later the bladder was again opened and Teflon paste injected in the space behind the intravesical ureter, thereby creating a support for the submucosal ureter. Cystography four to six weeks after injection of Teflon paste showed absence of r...
Full Text Available This study aimed to examine the efficacy of epirubicin-loaded gelatin hydrogel (EPI-H in the treatment of superficial urothelium carcinoma. Hydrogel was prepared by Schiff base-crosslinking of gelatin with glutaraldehyde. EPI-H exhibited high entrapment efficiency (59.87% ± 0.51%. EPI-H also increased epirubicin accumulation in AY-27 cells when compared with the effect of aqueous solutions of epirubicin (EPI-AQ; respective epirubicin-positive cell counts were 69.0% ± 7.6% and 38.3% ± 5.8%. EPI-H also exhibited greater cytotoxicity against AY-27 cells than that of EPI-AQ; IC50 values were 13.1 ± 1.1 and 7.5 ± 0.3 μg/mL, respectively. Cystometrograms showed that EPI-H reduced peak micturition, threshold pressures, and micturition duration, and that it increased bladder compliance more so than EPI-AQ. EPI-H enhanced epirubicin penetration into basal cells of urothelium in vivo, whereas EPI-AQ did so only to the umbrella cells. EPI-H inhibited tumor growth upon intravesical instillation to tumor-bearing bladder of F344 rats, inducing higher levels of caspase-3 expression than that observed with EPI-AQ treatment; the number of caspase-3 positive cells in treated urothelium carcinoma was 13.9% ± 4.0% (EPI-AQ and 34.1% ± 1.0%, (EPI-H. EPI-H has value as an improved means to administer epirubicin in intravesical instillation treatments for bladder cancer.
Full Text Available Context: The therapeutic strategy in intermediate risk (IR non-muscle invasive bladder cancer (NMIBC recurring after intravesical therapy (IT is not well defined. Most patients are usually retreated by Bacillus Calmette-Guerin (BCG. Aims: To evaluate the efficacy of intravesical chemotherapy (ICH given at recurrence after the first cycle of ICH in IR-NMIBC recurring 6 months or later. Settings and Design: Retrospective analysis of the efficacy of ICH given after previous IT. Materials and Methods: The clinical files of IR-NMIBC patients recurring later than 6 months after transurethral resection (TUR and IT and retreated by IT were reviewed. The patients should be at intermediate risk both initially and at the first recurrence. BCG should have been given at full dose. Cytology and cystoscopy were performed 3 monthly for 2 years and then 6 monthly. Statistical Analysis: The RFS was estimated by the Kaplan-Meier method and the differences between treatment groups were compared by log-rank test. Mann Whitney U-test was used to compare the parameters′ distribution for median time to recurrence. Multivariate Cox proportional hazards models were used. Results: The study included 179 patients. The first IT was ICH in 146 (81.6% and BCG in 33 (18.4%, re-IT was ICH in 112 (62.6% and BCG in 67 (37.4% patients. Median time to recurrence was 18 and 16 months after first and second IT (P = 0.32. At 3 years, 24 (35.8% and 49 (43.8% patients recurred after BCG and ICH, respectively (P = 0.90. No difference in RFS was found between BCG and ICH given after a first cycle of ICH (P = 0.23. Conclusions: Re-treatment with ICH could represent a legitimate option to BCG in patients harboring IR-NMIBC recurring after TUR and previous ICH. Prospective trials are needed.
Velaer, Kyla N; Steinberg, Ryan L; Thomas, Lewis J; O'Donnell, Michael A; Nepple, Kenneth G
Patients with high-grade muscle invasive bladder cancer (NMIBC) receive intravesical therapy with bacillus Calmette-Guérin (BCG) as the well-established standard-of-care. However, even with prompt induction of intravesical therapy, approximately 40 % of patients will recur within 2 years. For patients who fail BCG, options include radical cystectomy, repeat BCG therapy, or alternative intravesical salvage therapy. In this review, we will discuss the most recent published evidence on salvage intravesical therapy with an emphasis on a more in-depth report of our therapeutic strategy with sequential gemcitabine and docetaxel intravesical therapy for this treatment-refractory population. In addition, we will provide practical advice on our approach to this challenging patient population including the use of operative staging to aid early identification of treatment failures. PMID:26968418
Bogen handler om den praksis, vi kalder administration. Vi er i den offentlige sektor i Danmark hos kontorfolkene med deres sagsmapper, computere, telefoner,, lovsamlinger,, retningslinier og regneark. I bogen udfoldes en mangfoldighed af konkrete historier om det administrative arbejde fra...... forskellige områder i den offentlige sektor. Hensigten er at forstå den praksis og faglighed der knytter sig til det administrative arbejde...
Jo, Dae-Jin; Lee, Young-Suk; Oh, Tae-Hee; Ryu, Dong-Su; Kwak, Kyung-Won
Purpose To present outcomes of transurethral removal (TUR) of intravesical or intraurethral mesh after midurethral slings. Materials and Methods This was a retrospective chart review of 23 consecutive women: 20 with intravesical mesh and 3 with intraurethral mesh. Results To remove the mesh, transurethral resection with an electrode loop (TUR-E) was used in 16 women and transurethral resection with a holmium laser (TUR-H) was used in 7. The median follow-up was 2.1 months. Twenty-six percent ...
Agnelli, Giancarlo; Gresele, Paolo; de Cunto, Maria; del Favero, Albano
Intravesical instillation of thiotepa is a popular treatment for localized bladder carcinoma. The drug can enter the systemic circulation, and such absorption may be enhanced by extensive tumour infiltration or by a recent tumour resection. A case is reported of early onset life-threatening pancytopenia following an unusually low dose of the drug in a patient who had undergone a recent tumour resection.
Objective: To compare the result of T2/T3 transitional cell carcinoma (TCC) of the urinary bladder after segmental cystectomy, treated by postoperative radiation plus intravesical chemotherapy and postoperative intravesical chemotherapy alone. Methods: From 1985 to Dec. 1995 patients with T2/T3 TCC bladder cancer who had been treated by segmental cystectomy were eligible for this retrospective analysis. Fifty-eight patients received postoperative radiotherapy plus intravesical chemotherapy (RT + IVC) and 35 patients were given postoperative intravesical chemotherapy (IVC) with thio-TEPA or Calmette-Gue' rin bacilli (BCG). For radiation, 8 or 18 MV X-ray was given with total dose of 50-60 Gy. Vesicoclysis was performed on 50-60 mg thio-TEPA twice per week and 0.5 mg BCG per week. Results: The 3-year local control rates of RT + IVC and IVC groups were 68.6% and 48.2% showing a difference statistically significant (x2 = 4.08, P = 0.044). The 3- and 5-year survival rates of RT + IVC and IVC groups were 70.7%, 49.5% and 59.9%, 35.7%, showing no significant difference (x2 = 1.77, P = 0.184). Among the 5 year survivors of the RT + IVC patients, 78.6% had their bladder preserved. Though untoward radiation reactions were severer, they were tolerated well. Conclusions: Combined radiation therapy plus intravesical chemotherapy is indicated for T2/T3 bladder cancer after segmental cystectomy. Multimodality therapy is more favored to improve both the local control and the possibility of preserving the bladder
Chung-Cheng Wang; Cheng-Ling Lee; Hann-Chorng Kuo
We investigated the efficacy and safety of intravesical onabotulinumtoxinA injection in patients with detrusor hyperactivity and impaired contractility (DHIC). Twenty-one patients with urodynamically proven DHIC and 21 age-matched patients with overactive bladder (OAB) with urodynamic detrusor overactivity were treated with intravesical injections of 100 U of onabotulinumtoxinA. The overactive bladder symptom score, urgency severity score, patient perception of bladder condition, global respo...
Lukacs, S.; B. Tschobotko; Szabo, N. A.; Andrew Symes
Intravesical Bacilli Calmette-Guérin (BCG) immunotherapy is a commonly used treatment for superficial bladder cancer. Although the treatment is well tolerated in 95% of cases, life-threatening side effects including BCG sepsis can occur. This report describes the case of an 82-year-old man with a background of lung disease. He developed septic shock and type two respiratory failure after receiving the sixth installation of intravesical BCG (TICE strain) immunotherapy for recurrent bladder Tra...
Kamo, Izumi; Kaiho, Yasuhiro; Miyazato, Minoru; Torimoto, Kazumasa; Yoshimura, Naoki
Urethral closure mechanisms during abrupt elevation of intravesical pressure (Pves) were investigated. During sneezing, the middle urethral closing response was observed and it still remained after opening the abdomen. The middle urethral response was almost completely abolished after bilateral transection of somatic nerves innervating the external urethral sphincter and the pelvic floor muscles, while bilateral transection of both pelvic nerves and hypogastric nerves had no effects. Somatic ...
Chowdhury, Anadi Roy; Dey, Ranjan Kumar
Bacille Calmette-Guérin (BCG) is an effective treatment for patients with superficial bladder cancer and bladder carcinoma in situ (CIS). It may cause side effects usually due to local and systemic inflammatory effects. We report a case of a male patient with non-invasive urothelial carcinoma of urinary bladder (Stage T1) who developed caseating granulomas on his glans penis as a complication of intravesical BCG immunotherapy. Though there are other reported cases of BCG dissemination noted i...
Agnelli, Giancarlo; Gresele, Paolo; de Cunto, Maria; del Favero, Albano
Intravesical instillation of thiotepa is a popular treatment for localized bladder carcinoma. The drug can enter the systemic circulation, and such absorption may be enhanced by extensive tumour infiltration or by a recent tumour resection. A case is reported of early onset life-threatening pancytopenia following an unusually low dose of the drug in a patient who had undergone a recent tumour resection. PMID:6812036
Two commonly used cystoscopic infusion fluids were examined to determine whether their infusion stimulates DNA synthesis of the bladder epithelium. Following a single intravesical dose of 0.5 ml of distilled water or 1.5% L-glycine solution, rats were killed periodically up to 1 week. A transient but significant increase in epithelial cell [3H]thymidine labeling was observed at 48 hr after distilled water instillation. Glycine solution did not stimulate DNA synthesis
Paula M.Y. Tang; Kenneth L.Y. Chung; Yvonne C.L. Leung; Judy W.S. Hung; Clarence C.W. Liu; Nicholas S.Y. Chao; Michael W.Y. Leung; Kelvin K.W. Liu
Premature and extremely low birth weight (ELBW) neonates are at high risk of developing multiple co-morbidities and often require urinary catheterization for various medical indications. Intra-vesical knotting of bladder catheter is a known but uncommon complication of this procedure. We report a case of an ELBW baby boy with a knotted bladder catheter requiring surgical retrieval. After an elective operation for the closure of patent ductus arteriosus, a 4 French urinary catheter was inserte...
Daher C. Chade
Full Text Available The management of non-muscle-invasive urothelial carcinoma of the bladder (UCB is a challenge for physicians and patients alike. This is largely due to the heterogeneous natural history of this disease, in which tumors range from indolent to rapidly progressive and eventually fatal. Moreover, the high rate of recurrence and progression cause significant morbidity, expense, and detriment to quality of life. The advent of effective and safe intravesical therapies has improved the management of non-muscle-invasive UCB. Nevertheless, despite over 30 years of research and clinical experience, the mechanism, risks, benefits, and optimal regimens and treatment algorithms remain unclear. Although immunotherapy with bacillus Calmette-Guerin (BCG has been the mainstay of intravesical treatment and represents a significant advance in the interaction of immunology and oncology, its clinical effectiveness is accompanied by a wide range of adverse events. Here, we review the literature on intravesical immunotherapy and chemotherapy with the aim of evaluating the clinical utility of the different treatments and providing recommendations. Many studies over the years have compared efficacy and toxicities of different agents and regimens, and certain conclusions are now well supported by high-level evidence. Future perspectives and promising advances in drug development are discussed and areas of improvement are identified in order to promote better cancer control and decrease the rate and severity of side-effects.
Full Text Available Introduction. We present a novel case of persistent autonomic dysreflexia in a pediatric spinal cord injury patient treated successfully with intravesical botulinum toxin. Study Design. A retrospective chart review of one patient seen at the Children’s Hospital of Wisconsin from 2006 to 2012 was performed. Results. A pediatric spinal cord injury patient with known neurogenic bladder presented with severe hypertension consistent with autonomic dysreflexia. His symptoms and hypertension did not improve with conservative measures, and he necessitated ICU admission and antihypertensive drips. He was taken to the operating room for intravesical botulinum toxin for refractory bladder spasms. Following this, his symptoms abated, and he was weaned off IV antihypertensives and returned to his baseline state. His symptoms were improved for greater than six months. Conclusions. There are few treatment options for the management of refractory autonomic dysreflexia. Intravesical botulinum toxin has never been reported for this use. Dedicated research is warranted to assess its efficacy, as it was used successfully to abort autonomic dysreflexia in this patient.
Lockwood, Gina; Durkee, Charles; Groth, Travis
Introduction. We present a novel case of persistent autonomic dysreflexia in a pediatric spinal cord injury patient treated successfully with intravesical botulinum toxin. Study Design. A retrospective chart review of one patient seen at the Children's Hospital of Wisconsin from 2006 to 2012 was performed. Results. A pediatric spinal cord injury patient with known neurogenic bladder presented with severe hypertension consistent with autonomic dysreflexia. His symptoms and hypertension did not improve with conservative measures, and he necessitated ICU admission and antihypertensive drips. He was taken to the operating room for intravesical botulinum toxin for refractory bladder spasms. Following this, his symptoms abated, and he was weaned off IV antihypertensives and returned to his baseline state. His symptoms were improved for greater than six months. Conclusions. There are few treatment options for the management of refractory autonomic dysreflexia. Intravesical botulinum toxin has never been reported for this use. Dedicated research is warranted to assess its efficacy, as it was used successfully to abort autonomic dysreflexia in this patient. PMID:27006855
A. Yu. Zubko
Full Text Available Objective: to enhance the efficiency of combined treatment for non-muscle-invasive bladder cancer ((NMIBC and to assess the results of its treatment using transurethral resection (TUR as monotherapy and in combination with intravesical adjuvant chemotherapy (CT.Subjects and methods. The results of treatment were analyzed in 59 patients with NMIBC. Twenty-two patients underwent TUR in Group 1; TUR and single intravesical injection of drugs were performed in 19 patients in Group 2; 18 patients had TUR and long-term intravesical CT.Results and discussion. The recurrence rates were 59.1, 57.9, and 38.89 % in Groups 1, 2, and 3, respectively. Intravesical CT was found to appreciably affect the prevention of recurrence in the area of resection. The rate of this recurrence was 31.81, 26.32, and 5.56 % in Groups 1, 2, and 3, respectively. Conclusion. Adjuvant intravesical chemotherapy CT is an effective method to prevent recurrent bladder cancer.
Hermann, G G; Petersen, K R; Zeuthen, J; Steven, K
The purpose of the study was to examine the effects of intravesical BCG treatment on the cytotoxicity, interleukin-2 (IL-2) production and distribution of the subsets of peripheral blood mononuclear cells (PBMC) in patients with carcinoma in situ of the bladder. Treatments were made in 6 patients...... during a conventional BCG treatment schedule. Four patients showed a complete response, one a partial response and one had a progressive disease after BCG treatment. Intravesical BCG did not induce significant changes in the cytotoxicity of PBMC. The distribution of NK-cells and T-cells also remained...
van Valenberg, Hans; Colombo, Renzo; Witjes, Fred
Although many treatment modalities and schedules for non-muscle-invasive bladder cancer (NMIBC) exist, all yet prove to have limitations. Therefore the search for new forms of therapy continues. One of these forms consists of combining intravesical chemotherapy, typically mitomycin C (MMC), with hyperthermia achieved by a microwave-applicator. We aimed to review the current status of intravesical radiofrequency (RF) induced chemohyperthermia (CHT) for NMIBC with regard to efficacy, adverse-events (AEs) and its future perspective. A search for RF-induced CHT in MEDLINE, Embase, Cochrane and ClinicalTrials.gov databases was performed. Relevant conference abstracts were searched for manually. If applicable, experts on the area were consulted. Papers were selected based on abstract and title. A table of newly published clinical trials since 2011 was constructed. No meta-analysis could be performed based on these new papers. Efficacy proved to be better for RF-induced CHT compared to both MMC alone and bacillus Calmette-Guérin (BCG) instillations, with the latter being based on just one abstract of a randomised controlled trial. The AE rate in CHT is higher compared to MMC instillation, but is similar compared to BCG, albeit different in the type of AE. In almost all studies no severe AEs are reported. Although heterogeneity in methodology exists, RF-induced CHT seems promising. However, alternative methods of applying hyperthermia are starting to present their first results, imposing as effective options too. Intravesical RF-induced CHT may become an alternative for BCG instillation, and possibly for cystectomy, although further level 1 evidence is required for both reliable and reproducible data on efficacy and adverse events. PMID:26905963
Sara Isabel Alcântara Lestre; Catarina Diogo Gameiro; Alexandre João; Maria João Paiva Lopes
A imunoterapia com o Bacilo Calmette-Guérin é amplamente usada no tratamento e profilaxia da neoplasia urotelial superficial. As complicações associadas ao tratamento são comuns. Os autores relatam um caso de inflamação granulomatosa do pênis, associada à terapia intravesical com Bacilo Calmette-Guérin, com múltiplos nódulos eritematosos indolores localizados na glande. É também efetuada uma revisão da literatura. A balanopostite granulomatosa é uma complicação rara associada à imunoterapia c...
Marín Vivó, G; Revuelta Escuté, M; Rodríguez Martínez, X
The measurement of intra-abdominal pressure (IAP) has been incorporated routinely in Critical Units in order to monitor and control those clinical situations that make us suspicious of intraabdominal hypertension (IAH). There are several methods to measure IAP [1-3]: direct measurement, a catheter inserted through suprapubic aspiration, although it is a discouraged procedure by being very invasive; and indirect measurement. In this method there are mainly three different techniques: Through femoral vein puncture: a catheter into the inferior vena cava is channeled. It is a technique being deprecated invasive, associated with venous thrombosis, retroperitoneal hematoma and infection. Through a gastric tube: impractical, requires managing large amounts of water associated with leakage through the pylorus risk. Through intravesical measurement: is the most commonly used method. The bladder catheter allows monitoring the PIA and diuresis and electrolyte control. This method has potential for infection associated with catheterization risk. Although this risk, it is considered the gold standard for the measurement of IAP. Have now been introduced to the market each measuring intravesical kits guaranteeing sterility circuit without disconnections. It is necessary to know the material and the correct procedure for measuring the PIA and how to interpret the results. PMID:24864414
Paula M.Y. Tang
Full Text Available Premature and extremely low birth weight (ELBW neonates are at high risk of developing multiple co-morbidities and often require urinary catheterization for various medical indications. Intra-vesical knotting of bladder catheter is a known but uncommon complication of this procedure. We report a case of an ELBW baby boy with a knotted bladder catheter requiring surgical retrieval. After an elective operation for the closure of patent ductus arteriosus, a 4 French urinary catheter was inserted into an ELBW baby boy for urine output monitoring and left in-situ. Resistance was encountered in attempt to remove the urinary catheter. Abdominal X Ray confirmed intra-vesical knotting of the tube. Knot unravelling by interventional radiology was attempted but was unsuccessful. Open extra-peritoneal bladder exploration was performed for the retrieval of the tightly knotted catheter. A 6 French transurethral Foley catheter was inserted for bladder drainage. Upon removal of the Foley's catheter on day 5 post op, the baby was able to void spontaneously. With literature review, we postulated the potential risk factors resulting in this potentially avoidable iatrogenic unusual complication. Recommendations were suggested to avoid further incidences.
Mackel, Charles E; Burke, Shane M; Huhta, Taylor; Riesenburger, Ron; Weller, Simcha J
Osteomyelitis is an infection of the bone that can involve the vertebral column. A rare cause of vertebral osteomyelitis is Mycobacterium bovis after intravesical Bacillus Calmette-Guerin (BCG) therapy for transitional cell carcinoma of the bladder. In this report, we describe the case of a 64-year-old male presenting with constitutional symptoms, progressive thoracic kyphosis, and intractable T11 and T12 radiculopathies over the proceeding six months. A CT scan revealed erosive, lytic changes of the T12 and L1 vertebrae with compression of the T12 vertebra. An MRI demonstrated T11-12 osteomyelitis with intervening discitis and extensive paraspinal enhancement with a corresponding hyperintensity on a short tau inversion recovery (STIR) sequence. A needle aspiration grew out Mycobacterial tuberculosis complex that was pansensitive to all antimicrobial agent therapies, except pyrazinamide on culture, a finding consistent with an M. bovis infection. The patient's infection and neurologic compromise resolved after transthoracic T11-12 vertebrectomies with decompression of the spinal cord and nerve roots as well as T10-L1 instrumented fusion and protracted antimicrobial therapy. The epidemiology and natural history of M. bovis osteomyelitis are reviewed and the authors emphasize a mechanism of vertebral inoculation to explain the predilection of M. bovis osteomyelitis in males after intravesical BCG therapy. PMID:27158574
Hernández, Medardo; Prieto, Dolores; Orensanz, Luis M; Barahona, María Victoria; Jiménez-Cidre, Miguel; Rivera, Luis; García-Sacristán, Albino; Simonsen, Ulf
The present study was designed to investigate whether potassium (K+) channels are involved in the relaxations to nitric oxide (NO) of pig intravesical ureteral preparations suspended in organ baths for isometric tension recordings. In ureteral strips treated with guanethidine (10−5 M) and atropine (10−7 M) to block adrenergic neurotransmission and muscarinic receptors, respectively, NO was either released from nitrergic nerves by electrical field stimulation (EFS, 0.5–10 Hz, 1 ms duration, 20 s trains), or exogenously-applied as an acidified solution of sodium nitrite (NaNO2, 10−6–10−3 M).Incubation with an inhibitor of guanylate cyclase activation by NO, methylene blue (10−5 M) did not change the basal tension of intravesical ureteral strips but inhibited the relaxation induced by EFS or exogenous NO on ureteral preparations contracted with the thromboxane analogue U46619 (10−7 M).Incubation with charybdotoxin (3×10−8 M) and apamin (5×10−7 M), which are inhibitors of large and small conductance calcium (Ca2+)-activated K+ channels, respectively, did not modify basal tension or the relaxations induced by EFS and exogenous NO. Treatment with charybdotoxin or apamin plus methylene blue (10−5 M) significantly reduced the relaxations to EFS and exogenous NO. However, in both cases the reductions were similar to the inhibition evoked by methylene blue alone. The combined addition of charybdotoxin plus apamin did not change the relaxations to EFS or exogenously added NO of the porcine intravesical ureter.Cromakalim (10−8–3×10−6 M), an opener of ATP-sensitive K+ channels, evoked a dose-dependent relaxation with a pD2 of 7.3±0.2 and maximum relaxant effect of a 71.8±4.2% of the contraction induced by U46619 in the pig intravesical ureter. The blocker of ATP-sensitive K+ channels, glibenclamide (10−6 M), inhibited markedly the relaxations to cromakalim.Glibenclamide (10−6 M) had no effect on the basal tone of
Wang, Chung-Cheng; Lee, Cheng-Ling; Kuo, Hann-Chorng
We investigated the efficacy and safety of intravesical onabotulinumtoxinA injection in patients with detrusor hyperactivity and impaired contractility (DHIC). Twenty-one patients with urodynamically proven DHIC and 21 age-matched patients with overactive bladder (OAB) with urodynamic detrusor overactivity were treated with intravesical injections of 100 U of onabotulinumtoxinA. The overactive bladder symptom score, urgency severity score, patient perception of bladder condition, global response assessment, voiding diary, and procedure-related adverse events (AE) at baseline, two weeks, one, three, and six months after treatment were assessed. The results showed that the subjective symptom scores improved significantly in both groups, and the scores did not differ between the groups. The decrease in urgency episodes and urgency urinary incontinence were noted in OAB patients but not in DHIC patients. Although the incidence of AEs was comparable between the groups, the therapeutic efficacy lasted for a mean of 4.9 ± 4.8 months in DHIC patients and 7.2 ± 3.3 months in OAB patients (p = 0.03). We concluded that the efficacy of intravesical onabotulinumtoxinA injection for DHIC patients was limited and short-term. Nevertheless, AEs did not increase in DHIC. Intravesical onabotulinumtoxinA might not be a good indication in patients with DHIC and high post-voiding residual urine. Physicians should inform patients of the potential benefits and risks of onabotulinumtoxinA injection for treatment of DHIC. PMID:26999209
Full Text Available We investigated the efficacy and safety of intravesical onabotulinumtoxinA injection in patients with detrusor hyperactivity and impaired contractility (DHIC. Twenty-one patients with urodynamically proven DHIC and 21 age-matched patients with overactive bladder (OAB with urodynamic detrusor overactivity were treated with intravesical injections of 100 U of onabotulinumtoxinA. The overactive bladder symptom score, urgency severity score, patient perception of bladder condition, global response assessment, voiding diary, and procedure-related adverse events (AE at baseline, two weeks, one, three, and six months after treatment were assessed. The results showed that the subjective symptom scores improved significantly in both groups, and the scores did not differ between the groups. The decrease in urgency episodes and urgency urinary incontinence were noted in OAB patients but not in DHIC patients. Although the incidence of AEs was comparable between the groups, the therapeutic efficacy lasted for a mean of 4.9 ± 4.8 months in DHIC patients and 7.2 ± 3.3 months in OAB patients (p = 0.03. We concluded that the efficacy of intravesical onabotulinumtoxinA injection for DHIC patients was limited and short-term. Nevertheless, AEs did not increase in DHIC. Intravesical onabotulinumtoxinA might not be a good indication in patients with DHIC and high post-voiding residual urine. Physicians should inform patients of the potential benefits and risks of onabotulinumtoxinA injection for treatment of DHIC.
Barua, Jayanta M; Arance, Ignacio; Angulo, Javier C; Riedl, Claus R
Bladder pain syndrome/interstitial cystitis (BPS/IC) is a chronic disease characterised by persistent irritating micturition symptoms and pain. The objective was to compare the clinical efficacy of currently available products for intravesical therapy of BPS/IC and to assess their pharmacoeconomic impact. A Pubmed/Medline database search was performed for articles on intravesical therapy for BPS/IC. A total of 345 publications were identified, from which 326 were excluded. Statistical evaluation was performed with effect size (ES) assessment of symptom reduction and response rates. The final set of 19 articles on intravesical BPS/IC therapy included 5 prospective controlled trials (CTs), the remaining were classified as uncontrolled clinical studies. The total number of patients included was 801, 228 of whom had been evaluated in a CT. For CTs, the largest ES for symptom reduction as well as response rate was observed for high molecular weight hyaluronic acid (HMW-HA), with similar findings in two uncontrolled studies with HMW-HA. The number needed to treat to achieve a response to intravesical therapy was 2.67 for intravesical pentosan polysulphate and 1.31 for HMW-HA which were superior to all other instillates. HMW-HA was significantly superior in cost effectiveness and cost efficacy to all other instillation regimes. The present meta-analysis combined medical and pharmacoeconomic aspects and demonstrated an advantage of HMW-HA over other instillation agents; however, direct comparisons between the different products have not been performed to date in properly designed controlled studies. PMID:26590137
Hernández, Medardo; Barahona, María Victoria; Simonsen, Ulf; Recio, Paz; Rivera, Luis; Martínez, Ana Cristina; García-Sacristán, Albino; Orensanz, Luis M; Prieto, Dolores
This study was designed to investigate the effect of 5-hydroxytryptamine (5-HT) and to characterize the 5-HT receptors involved in 5-HT responses in the pig intravesical ureter. 5-HT (0.01–10 μM) concentration-dependently increased the tone of intravesical ureteral strips, whereas the increases in phasic contractions were concentration-independent. The 5-HT2 receptor agonist α-methyl 5-HT, mimicked the effect on tone whereas weak or no response was obtained with 5-CT, 8-OH-DPAT, m-chlorophenylbiguanide and RS 67333, 5-HT1, 5-HT1A, 5-HT3 and 5-HT4 receptor agonists, respectively. 5-HT did not induce relaxation of U46619-contracted ureteral preparations. Pargyline (100 μM), a monoaminooxidase A/B activity inhibitor, produced leftward displacements of the concentration-response curves for 5-HT. 5-HT-induced tone was reduced by the 5-HT2 and 5-HT2A receptor antagonists ritanserine (0.1 μM) and spiperone (0.2 μM), respectively. However, 5-HT contraction was not antagonized by cyanopindolol (2 μM), SDZ–SER 082 (1 μM), Y-25130 (1 μM) and GR 113808 (0.1 μM), which are respectively, 5-HT1A/1B, 5-HT2B/2C, 5-HT3, and 5-HT4 selective receptor antagonists. Removal of the urothelium did not modify 5-HT-induced contractions. Blockade of neuronal voltage-activated sodium channels, α-adrenergic receptors and adrenergic neurotransmission with tetrodotoxin (1 μM), phentolamine (0.3 μM) and guanethidine (10 μM), respectively, reduced the contractions to 5-HT. However, physostigmine (1 μM), atropine (0.1 μM) and suramin (30 μM), inhibitors of cholinesterase activity, muscarinic- and purinergic P2-receptors, respectively, failed to modify the contractions to 5-HT. These results suggest that 5-HT increases the tone of the pig intravesical ureter through 5-HT2A receptors located at the smooth muscle. Part of the 5-HT contraction is indirectly mediated via noradrenaline release from sympathetic nerves. PMID:12522083
Zaré Cyprien; Kambou Timothée; Sanon B. Gustave; Ouattara Adama; Traoré I. Alain; Paré Abdoul Karim; Somé D. Adolphe
We reported a case of an intravesical foreign body in a 16 years old teenager for abortion attempt. During laparotomy for suspected pelvic appendicitis, we incidentally discovered an intravesical foreign body. From this first observation in our urology division, we reviewed the literature on the nature and circumstance of self introduction in bladder of foreign body and their surgical ablation. We emphasized the importance of endoscopy as a support of diagnosis and ther...
Weintraub, Michael D; Li, Qingdi Quentin; Agarwal, Piyush K
The knowledge of tumor biology and the biomechanical properties of the urothelium have led to significant advances in the development of intravesical therapy for the treatment of non-muscle invasive bladder cancer (NMIBC). Targeted therapy improves the efficacy and decreases the side effects of antineoplastic agents. Nanoparticles that target antitumor agents to the urothelial cells have allowed for improved delivery of these agents to tumor cells. Gene therapy is another strategy that has allowed for a targeted induction of an antitumor response. Finally, engineering of the bacillus Calmette-Guérin (BCG) vaccine aimed to minimize the potential side effects associated with this treatment. These novel approaches hold promise for decreasing the rate of progression and recurrence of NMIBC. PMID:25054027
Baumgartner, Reinhold; Kriegmair, M.; Stepp, Herbert G.; Lumper, W.; Heil, Peter; Riesenberg, Rainer; Stocker, Susanne; Hofstetter, Alfons G.
Delta Aminolevulinic acid (ALA), a precursor of Protoporphyrin IX (PP IX) in hem biosynthesis has been topically applied in urinary bladders in order to study its potential as fluorescent tumor marker. Preclinical experiments have been performed on chemically induced tumors in rats, revealing a ratio of PP IX-fluorescence intensity up to 20:1 in tumors as compared to healthy urothelium. Synthesis of PP IX has been stimulated in 56 patients by intravesical instillation of a pH-neutral ALA-solution. After an incubation time of two to four hours strong red fluorescence was endoscopically observed even in tiny superficial tumors. Brightness and contrast allows visualization of early stage urothelial diseases with naked eyes and without the necessity suppressing background fluorescence or violet excitation light.
The aim of the present study was to analyze the pattern of recurrences after bladder-preserving therapy for muscle-invasive bladder cancer. The subjects were 77 patients with T2-3N0M0 bladder cancer whose bladder was preserved by intra-arterial chemotherapy and radiation. The patterns of the first recurrences were retrospectively analyzed. With a median follow-up of 38.5 months, 17 patients (22.1%) experienced intravesical recurrence without metastasis, 14 (82.4%) of which were cases of non-muscle-invasive bladder cancer recurrence and 3 (17.6%) of which were muscle-invasive bladder cancer recurrences. Muscle-invasive bladder cancer recurred at the same site as the initial tumor site in all three cases, whereas non-muscle-invasive bladder cancer recurred at different sites in 64% of the patients in that group. The peak hazard of the non-muscle-invasive bladder cancer recurrence was observed at around a year after treatment. Recurrent non-muscle-invasive bladder cancer was of a significantly lower histological grade with lower Ki-67-labeling indices than the initial muscle-invasive bladder cancer. Twelve (85.7%) of 14 patients with non-muscle-invasive bladder cancer recurrence achieved disease-free status. The multivariate analysis revealed that multiplicity, grade and tumor size were significantly correlated with the recurrence (P=0.0001, 0.0442 and 0.0412, respectively). Most of the recurrences after bladder-preserving therapy were cases of non-muscle-invasive bladder cancer. The recurrence pattern and characteristics of the tumors did not differ from those of primary non-muscle-invasive bladder cancer. Patients with high-risk factors would be candidates for prophylactic intravesical therapy for non-muscle-invasive bladder cancer recurrence. (author)
Harving, Signe Sofienberg; Asmussen, Lisa; Roosen, Jens U;
Only a few cases of tuberculous epididymo-orchitis after bacillus Calmette-Guérin (BCG) therapy have been published. This report presents a case of granulomatous epididymo-orchitis after intravesical BCG therapy in a patient presenting with pain and unilateral swelling of the scrotal content. Thi...... complication should always be considered when a patient presents with these symptoms after BCG therapy. Isoniazid may be used as a first choice of treatment.......Only a few cases of tuberculous epididymo-orchitis after bacillus Calmette-Guérin (BCG) therapy have been published. This report presents a case of granulomatous epididymo-orchitis after intravesical BCG therapy in a patient presenting with pain and unilateral swelling of the scrotal content. This...
Harving, S.S.; Asmussen, L.; Roosen, Jens Ulrik;
Only a few cases of tuberculous epididymo-orchitis after bacillus Calmette-Guerin (BCG) therapy have been published. This report presents a case of granulomatous epididymo-orchitis after intravesical BCG therapy in a patient presenting with pain and unilateral swelling of the scrotal content. Thi...... complication should always be considered when a patient presents with these symptoms after BCG therapy. Isoniazid may be used as a first choice of treatment Udgivelsesdato: 2009......Only a few cases of tuberculous epididymo-orchitis after bacillus Calmette-Guerin (BCG) therapy have been published. This report presents a case of granulomatous epididymo-orchitis after intravesical BCG therapy in a patient presenting with pain and unilateral swelling of the scrotal content. This...
Kim, Myung Soo; Park, Kyung Kgi; Chung, Byung Ha; Lee, Seung Hwan
Purpose Intravesical protrusion of the prostate (IPP) can affect voiding. We evaluated the improvement in lower urinary tract symptoms and patient satisfaction after laser prostate photovaporization in benign prostatic hyperplasia (BPH) patients with or without IPP. Materials and Methods This prospective study included 134 patients who underwent GreenLight HPS laser photoselective vaporization prostatectomy (PVP) between January 2010 and July 2011 patient. Preoperative IPP was evaluated by us...
Full Text Available Intravesical Bacilli Calmette-Guérin (BCG immunotherapy is a commonly used treatment for superficial bladder cancer. Although the treatment is well tolerated in 95% of cases, life-threatening side effects including BCG sepsis can occur. This report describes the case of an 82-year-old man with a background of lung disease. He developed septic shock and type two respiratory failure after receiving the sixth installation of intravesical BCG (TICE strain immunotherapy for recurrent bladder Transitional Cell Carcinoma in situ. Despite the early initiation of broad spectrum antibiotics (tazocin and gentamicin, he remained pyrexial. There was a rapid deterioration, and on the second day of his admission, he developed type two respiratory failure secondary to Acute Respiratory Distress Syndrome (ARDS prompting transfer to Intensive Care for Bilevel Positive Airway Pressure (BiPAP Ventilation. The blood cultures taken before the induction of antibiotics results were negative. Increasing clinical suspicion of systemic BCG-osis prompted the initiation of antituberculosis therapy (ethambutol, isoniazid rifampicin and steroids. Following six days of BiPAP and anti-tuberculosis therapy in ITU, his condition started to improve. Following a prolonged hospital stay he was discharged on long term ethambutol therapy. BCG-osis is a well-known though rare side effect of intravesical BCG therapy. We would like to highlight the importance of having a low threshold for starting anti-TB treatment.
Lukacs, S; Tschobotko, B; Szabo, N A; Symes, Andrew
Intravesical Bacilli Calmette-Guérin (BCG) immunotherapy is a commonly used treatment for superficial bladder cancer. Although the treatment is well tolerated in 95% of cases, life-threatening side effects including BCG sepsis can occur. This report describes the case of an 82-year-old man with a background of lung disease. He developed septic shock and type two respiratory failure after receiving the sixth installation of intravesical BCG (TICE strain) immunotherapy for recurrent bladder Transitional Cell Carcinoma in situ. Despite the early initiation of broad spectrum antibiotics (tazocin and gentamicin), he remained pyrexial. There was a rapid deterioration, and on the second day of his admission, he developed type two respiratory failure secondary to Acute Respiratory Distress Syndrome (ARDS) prompting transfer to Intensive Care for Bilevel Positive Airway Pressure (BiPAP) Ventilation. The blood cultures taken before the induction of antibiotics results were negative. Increasing clinical suspicion of systemic BCG-osis prompted the initiation of antituberculosis therapy (ethambutol, isoniazid rifampicin) and steroids. Following six days of BiPAP and anti-tuberculosis therapy in ITU, his condition started to improve. Following a prolonged hospital stay he was discharged on long term ethambutol therapy. BCG-osis is a well-known though rare side effect of intravesical BCG therapy. We would like to highlight the importance of having a low threshold for starting anti-TB treatment. PMID:23844314
Danişman, A; Bulut, K; Kukul, E; Ozen, I; Sevük, M
Intravesical bacillus Calmette-Guérin (BCG) has been shown to be an effective treatment for superficial transitional cell carcinoma (TCC) of the bladder, but the precise mechanism of action of BCG remains poorly understood. Fibronectin (FN), an important component of the extracellular matrix, has been found to play a role in BCG therapy. Some studies have shown that the soluble form of FN can compete efficiently with the matrix form of binding to the specific receptors on the bacteria and could consequently diminish the effect of BCG treatment. To evaluate a possible correlation between the urinary levels of FN and the efficacy of BCG therapy, we determined prospectively the urinary FN levels in 38 patients with TCC of the bladder and in 25 control subjects without malignancy matched for age and sex. All TCC patients were treated with transurethral tumor resection plus 6 weekly intravesical BCG instillations. After an average follow-up of 30 months, 8 patients (21.1%) had recurrent tumors, while 30 (78.9%) were free of tumor after intravesical BCG therapy. Urinary levels of FN in cancer patients have been shown to be significantly higher than controls (p 0. 05). It was also found that the mean urinary FN levels were not statistically significant between patients with recurrence and complete remission. The data suggest that BCG-bladder tumor cell binding is not influenced by soluble fibronectin and urinary FN may not be a ideal marker for selecting patients to BCG therapy. PMID:10895085
Ratliff, T L; Kavoussi, L R; Catalona, W J
Intravesical bacillus Calmette-Guerin (BCG) has been demonstrated to be effective both for prophylaxis and treatment of superficial bladder cancer. In order to identify the progression of events that result in BCG-mediated antitumor activity, studies were performed to evaluate the mechanism of binding of BCG within the bladder. Histological and quantitative studies in a mouse model revealed that BCG attached to the bladder wall only in areas of urothelial damage. Preliminary in vitro data showed that BCG attached to surfaces coated with extracellular matrix proteins. Further studies were then performed using purified extracellular matrix proteins to identify the proteins responsible for attachment. BCG were observed to attach to surfaces coated only with purified fibronectin (FN) but not to other purified proteins including laminin, collagen or fibrinogen. The attachment of BCG to purified FN in vitro was dose dependent and was inhibited by anti-FN antibodies. Moreover, BCG attachment in vivo to bladders with damaged urothelial surfaces was inhibited more than 95% by anti-FN antibodies, but binding was not affected by anti-laminin antibodies or preimmune serum. A survey of commercially available BCG vaccines (Pasteur, Tice, Glaxo, Connaught) showed that only Glaxo BCG did not attach to FN-coated surfaces. Glaxo BCG also was shown to express inferior antitumor activity suggesting that the absence of FN binding by Glaxo may have been associated with the absence of antitumor activity of the vaccine. PMID:3276931
Ueda, Norichika; Kobayashi, Yasuyuki; Arai, Hiroki; Honda, Masahito; Yoshida, Kyotaro
A 63-year-old man who presented with asymptomatic gross hematuria was referred to our hospital. Left ureteral tumor (cT3N0M0) was diagnosed and left nephroureterectomy was performed. Pathological examination revealed urothelial carcinoma and small cell carcinoma with local invasion (pT3). The patient was treated with three cycles of adjuvant chemotherapy with gemcitabine and cisplatin. Three months after the chemotherapy, cystoscopy showed an intravesical recurrence of the tumor. Transurethral resection was performed and histopathological examination revealed small cell carcinoma (pT1). We recommended a cystectomy and neoadjuvant chemotherapy with etoposide and carboplatin according to the standard care of small cell carcinoma of bladder. However, the patient refused to undergo cystectomy and desired to preserve his bladder. Therefore, after two cycles of chemotherapy with etoposide and carboplatin, transurethral resection was performed to examine the presence of the residual tumor instead of immediate cystectomy. Because of no residual tumor, another two cycles of chemotherapy were added instead of a cystectomy. There is no evidence of recurrence seven months after the chemotherapy. PMID:27018413
MohammadReza Rafati; Bizhan Kouchaki
Bacillus Calmette-Guérin (BCG) is indicated for treatment of primary or relapsing flat urothelial cell carcinoma in situ (CIS) of the urinary bladder. Disseminated infectious complications occasionally occur due to BCG as a vaccine and intravesical therapy. Intramuscular (IM) or Intravenous (IV) administrations of BCG are rare medication errors which are more probable to produce systemic infections. This report presents 13 years old case that several steps medication errors occurred conseque...
Hassan, Masroor; Qureshi, Asim; Nasir, Humaira
Verrucous carcinoma (VC) is a locally invasive, non-metastasising well differentiated variant of squamous cell carcinoma. It is very rare in the urinary bladder and mostly associated with schistosomiasis. It has a characteristic multilobular appearance with small surface projections on contrast cystogram. Owing to its bland cytology, it is a challenging diagnosis. We report a case of VC of the bladder-unrelated to schistosomiasis and involving the prostate-that recurred after transurethral resection of the tumour and prostate followed by six doses of intravesical mitomycin. To the best of our knowledge, no such case has been reported from Pakistan. PMID:27307433
Eric K. Diner
Full Text Available We report an 81-year-old male who developed severe interstitial pneumonitis on maintenance intravesical Bacillus Calmette-Guerin (BCG for in-situ carcinoma of the bladder. The patient was treated with steroids and anti-tuberculin therapy with complete response. While there is no established standard of care for the treatment of interstitial pneumonitis, recent reports describe success with combination of corticosteroids and anti-tuberculin medications. We elected to follow this precedent and treated our patient with corticosteroids and anti-tuberculin therapy with good outcome.
Aim: To evaluate magnetic resonance imaging (MRI) findings of granulomatous prostatitis (GP) developing after intravesical Bacillus Calmette–Guérin (BCG) therapy. Materials and methods: Ten patients with pathologically proven GP underwent prostatic MRI. Lesion shape and signal intensity (SI) were evaluated on T2-weighted (T2WI), T1WI, and diffusion-weighted imaging (DWI). Results: Polygonal nodular lesions with notches, diffuse lesions, and cystic lesions with mural nodules were seen in two, six, and one patients, respectively. The remaining patient had a diffuse and cystic lesion. All diffuse lesions showed higher SI than muscle on T1WI and higher SI than the normal peripheral zone (PZ) on DWI. On T2WI, six of seven diffuse lesions showed a slightly lower SI than bone marrow and the remaining one lesion was iso-intense. All nodular lesions showed a low SI similar to muscle on T2WI and were iso-intense to muscle on T1WI. On DWI, two each of the four nodular lesions showed slightly lower SI and slightly higher SI than the normal PZ, respectively. All contents within the cyst and mural nodules showed markedly high and low SI on T2WI, respectively. On DWI, all fluids within cysts showed markedly high SI. One each of the mural nodules showed slightly higher SI and slightly lower SI than the normal PZ on DWI. Conclusion: Three main MRI patterns of GP were identified: diffuse, nodular, and cystic with mural nodule; among them, the diffuse type was the most common. Cystic lesions with mural nodules could accompany the lesion
Heemstra, Karen A; Bossink, Ailko W J; Spermon, Roan; Bouwman, John J M; van der Kieft, Robert; Thijsen, Steven F T
In this case series, we describe four cases in which the use of gamma interferon release assays with purified protein derivative (PPD) as a stimulating antigen was able to demonstrate PPD-specific immune activation. This may help to improve the adequate diagnosis of (systemic) Mycobacterium bovis BCG infections after intravesical BCG instillations for bladder carcinoma. PMID:22461529
Heemstra, Karen A.; Bossink, Ailko W. J.; Spermon, Roan; Bouwman, John J. M.; van der Kieft, Robert; Thijsen, Steven F. T.
In this case series, we describe four cases in which the use of gamma interferon release assays with purified protein derivative (PPD) as a stimulating antigen was able to demonstrate PPD-specific immune activation. This may help to improve the adequate diagnosis of (systemic) Mycobacterium bovis BCG infections after intravesical BCG instillations for bladder carcinoma.
Sara Isabel Alcântara Lestre
Full Text Available A imunoterapia com o Bacilo Calmette-Guérin é amplamente usada no tratamento e profilaxia da neoplasia urotelial superficial. As complicações associadas ao tratamento são comuns. Os autores relatam um caso de inflamação granulomatosa do pênis, associada à terapia intravesical com Bacilo Calmette-Guérin, com múltiplos nódulos eritematosos indolores localizados na glande. É também efetuada uma revisão da literatura. A balanopostite granulomatosa é uma complicação rara associada à imunoterapia com Bacilo Calmette-Guérin, com uma apresentação clinicamente heterogênea que pode dificultar o diagnóstico. O seu reconhecimento clínico é essencial para o início precoce de tuberculostáticos e interrupção de Bacilo Calmette-GuérinImmunotherapy with Bacillus Calmette-Guérin is widely used for treatment and prophylaxis of superficial urothelial cancer. Complications associated with Bacillus Calmette-Guérin treatment are common. The authors describe a case of granulomatous inflammation of the penis associated with intravesical Bacillus Calmette-Guérin therapy, presenting with multiple erythematous and painless nodules located on the glans. A review of the literature is also performed. Granulomatous balanoposthitis is a rare complication of Bacillus Calmette-Guérin immunotherapy, with heterogeneous clinical presentation, which can make the diagnosis difficult. Its clinical recognition is essential for early start of therapy with antitubercular agents and interruption of Bacillus Calmette-Guérin
Full Text Available Bacille Calmette-Guérin (BCG immunotherapy is widely used for the treatment of superficial bladder cancer. The authors believe that the present report is one of the first to document cerebral BCG tuberculoma in a 73-year-old immunocompetent man, three years after intra-vesical BCG immunotherapy. His workup revealed no identifiable extracranial source. He responded well to treatment with rifampin, ethambutol and moxifloxacin.
Mugabe, Clement; Matsui, Yoshiyuki; So, Alan I; Gleave, Martin E; Heller, Markus; Zeisser-Labouèbe, Magali; Heller, Lindsay; Chafeeva, Irina; Brooks, Donald E; Burt, Helen M
The objective of this study was to evaluate the tolerability, to establish a dosing regimen, and to evaluate the efficacy of intravesical docetaxel (DTX) formulations in a mouse model of bladder cancer. DTX in commercial formulation (Taxotere, DTX in Tween 80) or loaded in hyperbranched polyglycerols (HPGs) was evaluated. The synthesis and characterization of HPGs with hydrophobic cores and derivatized with methoxy poly(ethylene glycol) in the shell and further functionalized with amine groups (HPG-C(8/10)-MePEG and HPG-C(8/10)-MePEG-NH(2)) is described. Intravesical DTX in either commercial or HPGs formulations (up to 1.0 mg/mL) was instilled in mice with orthotopic bladder cancer xenografts and was well tolerated with no apparent signs of local or systemic toxicities. Furthermore, a single dose of intravesical DTX (0.5 mg/mL) loaded in HPGs was significantly more effective in reducing the tumor growth in an orthotopic model of bladder cancer than the commercial formulation of Taxotere. In addition, DTX-loaded HPG-C(8/10)-MePEG-NH(2) was found to be more effective at lower instillation dose than DTX (0.2 mg/mL)-loaded HPG-C(8/10)-MePEG. Overall, our data show promising antitumor efficacy and safety in a recently validated orthotopic model of bladder cancer. Further research is warranted to evaluate its safety and efficacy in early phase clinical trials in patients refractory to standard intravesical therapy. PMID:21355626
Full Text Available Background/Aim. Transitional cell carcinoma (TCC is the most frequent tumor of the bladder and represents 95−98% of blader neoplasams and 2−3% of all carcinomas in the body. In urogenital oncology more frequent is only prostatic cancer. Evaluation of the depth of infiltration of urothelial carcinoma in the vesical wall represents the clinical base in treatment planning and prognosis. Clinical investigation and convential radiological procedures have a low level of accuracy in estimating the local growth of the tumor. The aims of our investigation were to determine the depth of infiltration of urothelial carcinoma in the vesical wall in the investigated group of patients by transurethral intravesical echotomography (TIE and computerised tomography (CT scan and to compare results obtained by both methods with pathohistological (PH results, and, based on the difference of the results determine which method was more accurate in the evaluation of the depth of infiltration of urothelial carcinoma in the vesical wall. Methods. Thirty patients with TCC of the bladder both genders, aged 51−81 years were involved in our investigation. In all of these patients, radical cystectomy (RC was performed. This was neccessary to provide the defintive PH result. Transurethral intravesical echotomography was performed by ultrasound scanner type 1846 Bruel and Kjaer, sond type 1850, and the CT scan was perfomed by Pace plus, General Electric, U.S.A. The specimen for the definitive PH result obtained by RC includes all standards of the TNM classification. Results. Using CT scan, the most frequent was T1 stage (17 patients or 56.68%. Using TIE, the most frequent was T2 stage (22 patients or 73.33%. After RC the most frequent was T2 stage (21 patients or 70%. The Kolmogorov-Smirnov test, showed a high significant difference between the results obtained using CT and definitive PH results after RC. The same test showed no statistically significant difference between
Pichl, Clara Maria; Feilhauer, Sophie; Schwaigerlehner, Rose-Marie; Gabor, Franz; Wirth, Michael; Neutsch, Lukas
Urinary tract infections (UTIs) are among the most common bacterial infections. Despite a wide range of therapeutic options, treatment success is compromised by multiresistance and the efficient mechanism of tissue colonization of uropathogenic Escherichia coli (UPEC). In advanced drug delivery systems, a similar, glycan-mediated targeting mechanism may be realized by conjugating the drug to a plant lectin. This may lead to the drug being more efficiently accumulated at the desired site of action, the bacterial reservoirs. In this study, we aimed at elucidating the potential of this biorecognitive approach. Glycan-triggered interaction cascades and uptake processes of several plant lectins with distinct carbohydrate specificities were characterized using single cells and monolayer culture. Due to pronounced cytoadhesive and cytoinvasive properties, wheat germ agglutinin (WGA) emerged as a promising targeter in porcine urothelial primary cells. The lectin-cell interaction proved highly stabile in artificial urine, simulating the conditions in actual application. Colocalisation studies with internalized WGA and lens culinaris agglutinin (LCA) revealed that intracellular accumulation sites were largely identical for GlcNAc- and Mannose-specific lectins. This indicates that WGA-mediated delivery may indeed constitute a potent tool to reach bacteria taken up via a FimH-triggered invasion process. Existing pitfalls in intravesical treatment schedules may soon be overcome. PMID:26383837
Full Text Available Bacillus Calmette-Guérin (BCG is indicated for treatment of primary or relapsing flat urothelial cell carcinoma in situ (CIS of the urinary bladder. Disseminated infectious complications occasionally occur due to BCG as a vaccine and intravesical therapy. Intramuscular (IM or Intravenous (IV administrations of BCG are rare medication errors which are more probable to produce systemic infections. This report presents 13 years old case that several steps medication errors occurred consequently from physician handwriting, pharmacy dispensing, nursing administration and patient family. The physician wrote βHCG instead of HCG in the prescription. βHCG was read as BCG by the pharmacy staff and 6 vials of intravesical BCG were administered IM twice a week for 3 consecutive weeks. The patient experienced fever and chills after each injection, but he was admitted 2 months after first IM administration of BCG with fever and pancytopenia. Unfortunately four month after using drug, during second admission duo to cellulitis at the sites of BCG injection the physicians diagnosed the medication error. Using handwritten prescription and inappropriate abbreviations, spending inadequate time for taking a brief medical history in pharmacy, lack of verifying name, dose and wrote before medication administration and lack of considering medication error as an important differential diagnosis had roles to occur this multi-steps medication error.
De Reijke, T M; De Boer, L C; Steerenberg, P A; Vos, P C; Kurth, K H; Schamhart, D H
Immunotherapy with intravesical instillation of bacillus Calmette-Guérin (BCG) is an effective treatment for superficial bladder carcinoma. In the present study the BCG-induced immunological reaction in the guinea pig (PPD skin test, bladder wall infiltrates and number of cells in the iliac lymph nodes) was investigated after intravesical pretreatment with pentosan polysulphate (PPS), which modulated BCG attachment to the bladder wall. Pentosan polysulfate is a molecule comparable to the naturally occurring glycosaminoglycans (GAGs) of the bladder mucosa. The data obtained after six weekly instillations of BCG-RIVM (5 x 10(6) - 5 x 10(7) cfu) with or without preinstillation with PPS (10 mg. in 1 ml. for 0.5 hour) suggested an elevation of the immunological reaction to intravesical BCG. A strong binding capacity of PPS to the mammalian bladder wall was observed. In addition, and in contrast to bacteria commonly causing cystitis, a significant binding of PPS to mycobacteria was found: 3.5, 3.6 and 3.1 micrograms./ml. dry weight of BCG Connaught, RIVM and Pasteur, compared with 0.2, 0.3, 0.7 and 0.0 microgram./mg. dry weight of Escherichia coli, Streptococcus faecalis, Klebsiella pneumoniae and Proteus. The results suggest that PPS enhances the attachment of BCG to the bladder wall, resulting in an increased BCG-induced immunological reaction in the guinea pig. It may be speculated that pretreatment with PPS may increase the efficacy of BCG therapy in man, especially in those patients not exhibiting an immunological reaction. PMID:7508528
Full Text Available Background and Aim: Bladder tumor is one of the most common genitourinary tumors. Management of non-muscle invasive (NMI bladder tumors is primarily by transurethral resection (TURBT followed by intravesical immunotherapy or chemotherapy. Bacillus Calmette-Guerin (BCG is the most effective adjuvant therapy in NMI bladder tumor. Since angiogenesis is an essential factor in solid tumor progression and vascular endothelial growth factor (VEGF is an important factor in angiogenesis, the aim of this study is the assessment of angiogenic factor, VEGF, serum and urine level changes in superficial bladder tumor immunotherapy by intravesical BCG. Materials and Methods: A total of 23 patients with bladder transitional cell carcinoma (TCC in stage Ta/T1 or carcinoma insitu (CIS, low or high grade, which passed a 2-4 week period from TURBT participated in this study. Blood and urine samples were obtained at first and sixth sessions before instillation of BCG. Enzyme-linked immunosorbent assay (ELISA method was used to obtain VEGF level in samples. Results: Urine and serum VEGF levels did not change significantly before and after BCG therapy. Changes in VEGF level were significantly different neither in low grade against high grade tumors nor in stage T1 against stage Ta tumors. A significant difference in VEGF level was seen between low grade and high grade tumors in serum after BCG therapy (P=0.007; but not in urine samples. Conclusion: Although intravesical BCG possesses anti-angiogenic activity, it seems that it exerts its effect through pathways other than VEGF, especially in low grade tumors.
Ratliff, T L; Palmer, J O; McGarr, J A; Brown, E J
Intravesical Bacillus Calmette-Guérin (BCG) is considered to be one of the most effective treatments for superficial bladder cancer. Although the mechanisms by which BCG inhibits tumor growth are not known, previous studies have shown that systemic immunization to BCG and the local expression of the immune response in the bladder are associated with a favorable response to BCG therapy. We have investigated the conditions required for the initiation of an immunological response after the intravesical instillation of BCG. Initial histological studies showed that BCG attached to the bladder wall only in areas where the urothelium was damaged by electrocautery and suggested that attachment was associated with the fibrin clot. Quantitative studies verified the histological observations. Minimal BCG attachment (mean less than 10(2) colony forming units) was observed in normal bladders in contrast with a mean of 1.42 X 10(4) colony forming units/bladder in bladders damaged by electrocautery (10 separate experiments). BCG attachment to the bladder wall was durable since organisms were observed in bladders 48 h after instillation. To investigate the proteins to which BCG attached, we tested the binding of BCG to extracellular matrix and inflammatory proteins which comprise a significant portion of the fibrin clot. BCG bound in vitro to coverslips coated in vivo with extracellular matrix proteins but did not bind to control albumin-coated coverslips. BCG also bound to coverslips coated with purified plasma fibronectin but not to coverslips coated with other purified extracellular matrix proteins including laminin, fibrinogen, and type IV collagen. BCG attachment to coverslips coated with either extracellular matrix proteins or purified fibronectin was inhibited by antibodies specific for fibronectin. Moreover, BCG attachment to cauterized bladders in vivo was inhibited by antifibronectin antibodies. These results demonstrate that fibronectin mediates the attachment of BCG
Full Text Available Abstract Background Despite being a mainstay for treating superficial bladder carcinoma and a promising agent for interstitial cystitis, the precise mechanism of Bacillus Calmette-Guerin (BCG remains poorly understood. It is particularly unclear whether BCG is capable of altering gene expression in the bladder target organ beyond its well-recognized pro-inflammatory effects and how this relates to its therapeutic efficacy. The objective of this study was to determine differentially expressed genes in the mouse bladder following chronic intravesical BCG therapy and to compare the results to non-specific pro inflammatory stimuli (LPS and TNF-α. For this purpose, C57BL/6 female mice received four weekly instillations of BCG, LPS, or TNF-α. Seven days after the last instillation, the urothelium along with the submucosa was removed from detrusor muscle and the RNA was extracted from both layers for cDNA array experiments. Microarray results were normalized by a robust regression analysis and only genes with an expression above a conditional threshold of 0.001 (3SD above background were selected for analysis. Next, genes presenting a 3-fold ratio in regard to the control group were entered in Ingenuity Pathway Analysis (IPA for a comparative analysis in order to determine genes specifically regulated by BCG, TNF-α, and LPS. In addition, the transcriptome was precipitated with an antibody against RNA polymerase II and real-time polymerase chain reaction assay (Q-PCR was used to confirm some of the BCG-specific transcripts. Results Molecular networks of treatment-specific genes generated several hypotheses regarding the mode of action of BCG. BCG-specific genes involved small GTPases and BCG-specific networks overlapped with the following canonical signaling pathways: axonal guidance, B cell receptor, aryl hydrocarbon receptor, IL-6, PPAR, Wnt/β-catenin, and cAMP. In addition, a specific detrusor network expressed a high degree of overlap with the
JIANG, SHANG-JUN; YE, LI-YIN; Meng, Fan-Hua
The aim of the present meta-analysis was to compare the benefits of Bacillus Calmetter-Guerin (BCG) and mitomycin C in the treatment of patients with superficial bladder cancer. The present meta-analysis analyzed the benefits of BCG and mitomycin C in the treatment of patients with superficial bladder cancer by comparing progression-free survival (PFS) rates in patients treated with either of the drugs following transurethral resection. The Medline, Cochrane and EMBASE databases were searched...
Elsäßer, Julia; Janssen, Martin W.; Becker, Frank; Suttmann, Henrik; Schmitt, Kai; Sester, Urban; Stöckle, Michael; Sester, Martina
Specific T cell immunity in patients with active tuberculosis is associated with a decrease in multifunctionality. However, it is unknown whether cytokine profiles differ in patients with primary infection and those with prior contact. We therefore used intravesical immunotherapy with attenuated live Bacille Calmette–Guérin (BCG) in patients with urothelial carcinoma as a model to characterise the induction of systemic immunity towards purified protein derivate (PPD) and to study whether cyto...
Wang, Junpeng; Wang, Qiang; Wu, Qinghui; Chen, Yang; Wu, Peng
BACKGROUND The role of intravesical botulinum toxin A (BTX-A) injections in bladder pain syndrome/interstitial cystitis (BPS/IC) has not been clearly defined. The aim of this study was to evaluate high-level evidence regarding the efficacy and safety of BTX-A injections for BPS/IC. MATERIAL AND METHODS We conducted a comprehensive search of PubMed, Embase, and Web of Science, and conducted a systematic review and meta-analysis of all available randomized controlled trials (RCTs) and controlled studies assessing BTX-A injections for BPS/IC. RESULTS Seven RCTs and 1 retrospective study were identified based on the selection criteria. Pooled analyses showed that although BTX-A was associated with a slightly larger volume of post-void residual urine (PVR) (weighted mean difference [WMD] 10.94 mL; 95% confidence intervals [CI] 3.32 to 18.56; p=0.005), patients in this group might benefit from greater reduction in pelvic pain (WMD -1.73; 95% CI -3.16 to -0.29; p=0.02), Interstitial Cystitis Problem Index (ICPI) scores (WMD -1.25; 95% CI -2.20 to -0.30; p=0.01), and Interstitial Cystitis Symptom Index (ICSI) scores (WMD -1.16; 95% CI -2.22 to -0.11; p=0.03), and significant improvement in daytime frequency of urination (WMD -2.36; 95% CI -4.23 to -0.49; p=0.01) and maximum cystometric capacity (MCC) (WMD 50.49 mL; 95% CI 25.27 to 75.71; p<0.00001). Nocturia, maximal urinary flow rate, dysuria, and urinary tract infection did not differ significantly between the 2 groups. CONCLUSIONS Intravesical BTX-A injections might offer significant improvement in bladder pain symptoms, daytime urination frequency, and MCC for patients with refractory BPS/IC, with a slightly larger PVR. Further well-designed, large-scale RCTs are required to confirm the findings of this analysis. PMID:27624897
A fast-paced, example-based guide to learning how to administrate, monitor, and optimize Apache Solr.""Administrating Solr"" is for developers and Solr administrators who have a basic knowledge of Solr and who are looking for ways to keep their Solr server healthy and well maintained. A basic working knowledge of Apache Lucene is recommended, but this is not mandatory.
Hewitt, Kimberly Kappler; Weckstein, Daniel K.
One of the biggest obstacles to overcome in creating and sustaining an administrative professional learning community (PLC) is time. Administrators are constantly deluged by the tyranny of the urgent. It is a Herculean task to carve out time for PLCs, but it is imperative to do so. In this article, the authors describe how an administrative PLC…
Seo, Gi Hyeon; Kim, Jae Heon; Ku, Ja Hyeon
We evaluated the frequency and practice pattern of immediate postoperative intravesical chemotherapy (PIC) after transurethral resection of a bladder tumor (TURBT) in suspected non-muscle-invasive bladder cancer (NMIBC). Information from the Health Insurance Review and Assessment Service database from January 1, 2008 to December 31, 2013 was used. Patients with bladder cancer who received TURBT were considered as the cases (37,941 patients and 59,568 cases). The time of PIC after TURBT, types of PIC regimens, and the potential effect of PIC on the delay for additional treatment were analyzed. The study cohort included 23,726 subjects and 30,473 cases with a mean age of 66.8 ± 12.0 years, including 19,362 (81.6%) male patients. The rate of immediate PIC was 11.0% of cases (3,359 cases). There was significant difference in the frequency rate of additional treatment among patients with immediate PIC and patients without immediate PIC within 1 year from the first TURBT (15.2% vs 16.6%, p = 0.035). However, no difference was revealed for whole observational period (33.7% vs 34.5%, p = 0.373). The frequency rate of immediate PIC after TURBT for suspected NMIBC was low in real clinical practice. More efforts are needed to improve the usage rate of PIC after TURBT for suspected NMIBC. PMID:26976048
Département des Ressources humaines
Administrative Circular N° 2 (Rev. 2) - May 2004 Guidelines and procedures concerning recruitment and probation period of staff members This circular has been revised. It cancels and replaces Administrative Circular N° 2 (Rev. 1) - March 2000. Administrative Circular N° 9 (Rev. 3) - May 2004 Staff members contracts This circular has been revised. It cancels and replaces Administrative Circular N° 9 (Rev. 2) - March 2000. Administrative Circular N° 26 (Rev. 4) - May 2004 Procedure governing the career evolution of staff members This circular has also been revised. It Administrative Circulars Administrative Circular N° 26 (Rev. 3) - December 2001 and brings up to date the French version (Rev. 4) published on the HR Department Web site in January 2004. Operational Circular N° 7 - May 2004 Work from home This circular has been drawn up. Operational Circular N° 8 - May 2004 Dealing with alcohol-related problems...
Through the example of a Danish reform of educational plans in early childhood education, the paper critically addresses administrative educational reforms promoting accountability, visibility and documentation. Drawing on Foucaultian perspectives, the relation between knowledge and governing...... administrative technology, tracing how the humanistic values of education embed and are embedded within ‘the professional nursery teacher' as an object and subject of administrative practice. Rather than undermining the humanistic potential of education, it is argued that the technology of accounting, in this...
McGarity, Augustus C., III; Maulding, Wanda
This article discusses how all four facets of administrative ecology help dispel the claims about the "impossibility" of the superintendency. These are personal ecology, professional ecology, organizational ecology, and community ecology. Using today's superintendency as an administrative platform, current literature describes a preponderance of…
This paper seeks to develop an understanding of the issues that public administrators should strive to provide in ethical practices and governance thus allowing distinctive administrative and social traditions that each country possess to flourish. Significant changes and continuities in the realm of government in contemporary China and Malaysia will be drawn upon. Recent developments have brought a sense of urgency in contrast to complacency with the status quo. This paper reviews pertinent ...
Nielsen, Elof Nellemann; Rehr, Preben René
En undervisningsbog der henvender sig til administrationsbacheloruddannelsen. Kapitlerne er inddelt efter modulerne på uddannelsen og indeholder derfor elementer af administration, forvaltning, økonomistyring, innovation, samfundsvidenskabelige metoder og politisk styrede organisationer.......En undervisningsbog der henvender sig til administrationsbacheloruddannelsen. Kapitlerne er inddelt efter modulerne på uddannelsen og indeholder derfor elementer af administration, forvaltning, økonomistyring, innovation, samfundsvidenskabelige metoder og politisk styrede organisationer....
SAT Administrator is the Information System for Nuclear Power Plant Personnel Training Program Design. It supports the design of training programs in the following phases: job analysis; task analysis; competency analysis; task competency association; definition of learning objectives to competencies; training program design; definition of test items. The general structure of the database and management software supports application of the SAT Administrator in any nuclear power installation
Fatal Renal Failure in a Spinal Cord Injury Patient with Vesicoureteric Reflux Who Underwent Repeated Ureteric Reimplantations Unsuccessfully: Treatment Should Focus on Abolition of High Intravesical Pressures rather than Surgical Correction of Reflux
Full Text Available A 29-year-old man developed paraplegia at T-10 level due to road traffic accident in 1972. Both kidneys were normal and showed good function on intravenous urography. Division of external urethral sphincter was performed in 1973. In 1974, cystogram showed retrograde filling of left renal tract, which was hydronephrotic. Left ureteric reimplantation was performed. Following surgery, cystogram revealed marked retrograde filling of left renal tract as before. Penile sheath drainage was continued. In 1981, intravenous urography revealed bilateral severe hydronephrosis. Left ureteric reimplantation was performed again in 1983. Blood pressure was 220/140 mm Hg; this patient was prescribed atenolol. Cystogram showed gross left vesicoureteral reflux. Intermittent catheterisation was commenced in 2001. In 2007, proteinuria was 860 mg/day. This patient developed progressive renal failure and expired in 2012. In a spinal cord injury patient with vesicoureteral reflux, the treatment should focus on abolition of high intravesical pressures rather than surgical correction of vesicoureteric reflux. Detrusor hyperactivity and high intravesical pressures are the basic causes for vesicoureteral reflux in spinal cord injury patients. Therefore, it is important to manage spinal cord injury patients with neuropathic bladder by intermittent catheterisations along with antimuscarinic drug therapy in order to abolish high detrusor pressures and prevent vesicoureteral reflux. Angiotensin-converting enzyme inhibitors or angiotensin-receptor-blocking agents should be prescribed even in the absence of hypertension when a spinal cord injury patient develops vesicoureteral reflux and proteinuria.
BRUCE, ROBERT L.; CARTER, G.L., JR.
IN THE COOPERATIVE EXTENSION SERVICE, STYLES OF LEADERSHIP PROFOUNDLY AFFECT THE QUALITY OF THE SERVICE RENDERED. ACCORDINGLY, MAJOR INFLUENCES ON ADMINISTRATIVE CLIMATE AND EMPLOYEE PRODUCTIVITY ARE EXAMINED IN ESSAYS ON (1) SOURCES OF JOB SATISFACTION AND DISSATISFACTION, (2) MOTIVATIONAL THEORIES BASED ON JOB-RELATED SATISFACTIONS AND NEEDS,…
The Internet and electronic commerce (e-commerce) generate lots of data. Data must be stored, organized, and managed. Database administrators, or DBAs, work with database software to find ways to do this. They identify user needs, set up computer databases, and test systems. They ensure that systems perform as they should and add people to the…
This article reviews relevant administrative decisions that have been taken in various countries during the last semester of 1999 and the first one of 2000. In Argentina, an inter-ministerial commission has been settled to examine the prospects of completing the construction of the Atucha-2 unit. In Sweden, an agreement has been signed between Sydkraft, Vattenfall and the Swedish government on a compensation plan for the early shutdown of the Barsebaeck unit 1. In Switzerland, the government of the canton of Bern has rejected a constitutional initiative requesting the shutdown of the Muehleberg nuclear power plant. (A.C.)
杨光天; 赵海岩; 温峰
目的 探讨经尿道钬激光切除联合吡柔比星即刻灌注治疗浅表性膀胱癌的临床疗效.方法 51例浅表性膀胱癌患者按随机数字表法分为两组,治疗组26例行经尿道膀胱肿瘤钬激光切除,术后即刻予以膀胱内保留灌注无菌蒸馏水50 ml+吡柔比星30 mg,1次；对照组25例行经尿道膀胱肿瘤电切治疗,两组术后拔除尿管时灌注1次,以后每周1次,共8次,后改为每月1次,持续至术后1年以上,随访15～39个月.结果 治疗组手术时间20～53 min,平均(31.6 ±8.9) min,无膀胱穿孔发生,术后留置导尿管1～5d,平均(2.7±0.6)d,4例复发；对照组手术时间13 ～47 min,平均(29.8±8.3)min,1例术中膀胱穿孔,术后留置导尿管3～11d,平均(4.6±1.1)d,11例复发.两组平均手术时间、膀胱穿孔例数差异均无统计学意义(均P＞0.05),治疗组术后导尿管留置时间、肿瘤复发例数均低于对照组(均P＜0.05).结论 经尿道钬激光切除联合吡柔比星灌注治疗浅表性膀胱肿瘤疗效优于电切治疗,术后恢复快.%Objective To study the efficacy of transurethral holmium laser resection as well as instant intravesical Pirarubicin instillation for superficial bladder carcinoma.Methods 51 cases with superficial bladder cancer were divided into observation group(A) including 26 cases and control group(B) including 25 cases stochastically.The 26 cases of group A were received transurethral holmium laser resection as well as instant intravesical Pirarubicin instillation therapy whereas 25 cases of group B received transurethral resection therapy.All patients of both groups were treated with intravesical instillation of Pirarubicin therapy regularly at least 1 year and have been followed up for 15 to 39 months.Results Differences were not significant between the two groups in the mean operation time and bladder perforation rate(P ＞0.05 ),but indwelling period of urethral catheter was markedly decreased in group A than group
The clinical course of non-muscle invasive bladder cancer after transuretral resection of the tumor with or without subsequent intravesical application of bacillus Calmette-Guérin: The influence of patients gender and age
Full Text Available Bacground/Aim. The therapy with intravesical instillation of bacillus Calmette-Guérin (BCG after transurethral resection (TUR of tumor is the gold standard of treatment of non-muscle invasive bladder cancer (NMIBC. The role and importance of BCG intravesical therapy in various shape of tumors, were confirmed by our previous investigation. The aim of this study was to examine whether incidence of recurrence and tumor regression differs depending on sex and age of patients. Methods. This study included a total of 899 patients suffering from NIMBC, treated at our institution from January 1, 2007 to March 1, 2013. Two groups of patients were formed: patients underwent TUR + BCG therapy (the group I and the group II with patients in whom TUR was performed as only therapy. These two groups of patients were divided into subgroups of respondents male and female, age 60 years or younger and older than 60 years. Statistical analysis was performed using χ2 test and the Kolmogorov-Smirnov test. Results. This research suggests that if the frequency of recurrence is seen as the only parameter, considering all the subjects, the lowest recurrence rate was determined in the male subjects, aged 60 years and younger who had received BCG after TUR. A high statistical significance was found in the incidence of recurrence in patients younger than 60 years, depending on the response to the therapy, while in those older than 60 years, the difference was at the level of statistical significance. This can be attributed to a certain degree of infravesical obstruction in older men. Conclusions. Sex and age of patients may have a significant influence on the course and outcome of NMIBC. The disease has the most malignant and most aggressive behavior when present in males older than 60 years.
The task of my master´s thesis was to work up a project and a check of a bearing steel construction the multi-storey office building with a garage in Brno. The building is composed of five storey office section and two storey of garage. Ground dimension of administrative part is 38,8m x 35m with distance of pillars 7m,6m and 6,4m. The structural height of floor is 3,5m.Garage is designed with dimensions 36m x 24,8m with structural height of floor 3,5m. Distance of pillars is 5,6m, 6,4m and 7,...
Division des ressources humaines
N° 2 (Rev. 1) - March 2000Guidelines and procedures concerning recruitment and probation period of staff membersN° 9 (Rev. 2) - March 2000Staff members contractsN° 16 (Rev. 2) - January 2000TrainingN° 30 (Rev. 1) - January 2000Indemnities and reimbursements upon taking up appointment and termination of contractN° 32 - February 2000Principles and procedures governing complaints of harassmentThese circular have been amended (No 2, N° 9, N° 16 and N° 30) or drawn up (N° 32).Copies are available in the Divisional Secretariats.Note:\tAdministrative and operational circulars, as well as the lists of those in force, are available for consultation in the server SRV4_Home in the Appletalk zone NOVELL (as GUEST or using your Novell username and password), volume PE Division Data Disk.The Word files are available in the folder COM, folder Public, folder ADM.CIRC.docHuman Resources DivisionTel. 74128
UDAYSINH R. MANEPATIL
Hospital administration is the management of the hospital as a business. The administration is made up of medical and health services managers (sometimes called health care executives and health care administrators) and assistant administrators. Administrations range in size and the duties of the administrator depends on the size of the administration.
Conradsen, Inger Marie; Gøtze, Michael
Administrative Appeals, review, administrative tribunals, ombudsman, alternative dispute resolution......Administrative Appeals, review, administrative tribunals, ombudsman, alternative dispute resolution...
Posner, Gary J.
Recognizing that termination is viewed by the employee as the equivalent to capital punishment of a career, an administrative contract can reduce the emotional and financial entanglements that often result. Administrative contracts are described. (MLW)
Department of Veterans Affairs — The Administrative Data Repository (ADR) was established to provide support for the administrative data elements relative to multiple categories of a person entity...
Chaffee, Ellen Earle
Patterns that emerged from reviewing 26 syllabi for courses on organization and administration in higher education are discussed, and six sample syllabi are presented. The syllabi focused more on organization than administration. Of the 26 syllabi, 19 dealt with organization and administration generally; 5 with administration in a specific…
In the thesis titled Organization of Public Administration I concentrated in the review of national and foreign literature. My decision for this topic is based on the personal interest and relevance of the topic in this particular period of time. The purpose of my work was to present the public administration in general, with focus in public administration of Slovenia. At first, the theoretical background of public administration is presented, with following topics addressed: public administr...
The activity of administrative bodies includes big numbers of various acts and actions, through which the will of public administration is formed. The will of public administration bodies, expressed in administrative individual and normative acts, in administrative contracts and real acts, finds its reflection in the Constitution, laws and other provisions of legal character. All this activity is not inerrant and therefore, it is not uncontrollable. The supervision of executive activity is su...
To understand the constant increase in administration, we need a new approach to the administration. For many years, the administration has intensified as a closed science, associated only with economics, law and political science. However, this approach did not bring anything good, because almost nothing in the administration has improved. Therefore, it is necessary to connect the administration with the natural sciences which give the best description of the world around us. Because of this...
Full Text Available The activity of administrative bodies includes big numbers of various acts and actions, through which the will of public administration is formed. The will of public administration bodies, expressed in administrative individual and normative acts, in administrative contracts and real acts, finds its reflection in the Constitution, laws and other provisions of legal character. All this activity is not inerrant and therefore, it is not uncontrollable. The supervision of executive activity is subject to political control of administrative acts through authorities designated for this purpose, as well as internal control and the judicial control. The institution of judicial control of administrative acts and actions appears as very important and widely treated in the legal doctrine. The protection of constitutional and legal rights of private persons is accomplished by subjecting administrative activity both to internal administrative control, as well as to the judicial control in accordance with legal provisions. The judicial control of administrative acts represents a constitutional guarantee for citizens to protect their rights through public and fair trial by an independent and impartial court. In this way, the Constitution empowers the common administrative court that invalidates an action or administrative act, but not all administrative acts may be subject to administrative dispute, with the exception of cases against which the administrative conflict cannot be carried out (negative enumeration.
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P. Williamson, Ian; Enemark, Stig; Wallace, Judy; Rajabifard, Abbas
This paper introduces basic land administration theory and highlights four key concepts that are fundamental to understanding modern land administration systems - firstly the land management paradigm and its influence on the land administration framework, secondly the role that the cadastre plays in contributing to sustainable development, thirdly the changing nature of ownership and the role of land markets, and lastly a land management vision that promotes land administration in support of ...
Dekker, M.A.C.; Etalle, S.
Flexibility of management is an important requisite for access control systems as it allows users to adapt the access control system in accordance with practical requirements. This paper builds on earlier work where we defined administrative policies for a general class of RBAC models. We present a formal definition of administrative refinnement and we show that there is an ordering for administrative privileges which yields administrative refinements of policies. We argue (by giving an examp...
Bachelor's Thesis deals with a development of administrative justice. The first part of the paper defines the term of administrative justice in general and then describes various types. The second part is focused on the history of administrative justice in our country. The third part describes the current legislation in the Czech Republic. The fourth section is entirely devoted to the Supreme Administrative Court. Define the function and organization at first and then there are analyzed speci...
The objective of the promotion work, based on the result analysis of the specific economical literature and tax administration praxis worldwide and in Latvia, is to elaborate proposals for the development of tax administration in Latvia. The work consists of three chapters. In the first chapter of the work viewpoints on the essence and functions of tax administration encountered in the scientific literature have been researched and factors affecting tax administration have been analyzed. T...
An easy-to-follow Apache Hadoop administrator's guide filled with practical screenshots and explanations for each step and configuration. This book is great for administrators interested in setting up and managing a large Hadoop cluster. If you are an administrator, or want to be an administrator, and you are ready to build and maintain a production-level cluster running CDH5, then this book is for you.
Elsäßer, Julia; Janssen, Martin W; Becker, Frank; Suttmann, Henrik; Schmitt, Kai; Sester, Urban; Stöckle, Michael; Sester, Martina
Specific T cell immunity in patients with active tuberculosis is associated with a decrease in multifunctionality. However, it is unknown whether cytokine profiles differ in patients with primary infection and those with prior contact. We therefore used intravesical immunotherapy with attenuated live Bacille Calmette-Guérin (BCG) in patients with urothelial carcinoma as a model to characterise the induction of systemic immunity towards purified protein derivate (PPD) and to study whether cytokine profiles differ depending on pre-existing immunity. Eighteen patients with non-muscle invasive bladder cancer were recruited during the BCG-induction course. Fifty-four healthy individuals served as controls. Interferon (IFN)-γ and interleukin (IL)-2 producing PPD-specific CD4 T cells were analysed longitudinally before each instillation using a rapid flow-cytometric whole blood immunoassay. Baseline levels of IFN-γ producing PPD-specific T cells were comparable to controls. T cells showed a 5-fold increase to 0.23% by week 2/3, and further increased 8-fold by week 4/5 (to 0.42%, p=0.0007). Systemic immunity was induced in all patients, although the increase was less pronounced in patients with pre-existing immunity. As in active TB, cytokine profiling during therapy revealed a lower percentage of multifunctional IFN-γ/IL-2 double-positive T cells compared to controls (60.2% vs. 71.9%, p=0.0003). Of note, when comparing patients with and without pre-existing immunity, cytokine profiles in patients with primary immunity were shifted towards IL-2 single producing T cells (p=0.02), whereas those in patients with pre-existing immunity were shifted towards IFN-γ single-positivity (p=0.01). In conclusion, systemic T cell responses were induced after BCG-therapy, and their kinetics and cytokine profile depended on pre-existing immunity. Decreased functionality is a typical feature of specific immunity in both patients with active tuberculosis and BCG-therapy. Among patients
Administration is the art of getting tasks done by utilizing the resources and coordinating the people. Administrators give trigger to the administration by coordinating, and directing all parts of an organization by managing the tangible and intangible resources of the organization. The qualities of leadership are therefore a critical determinant of organizational success. The theories of leadership (Trait to Transformational leadership theory) have strived to look into the aspects that make...
The Veterans Administration Information Resource Center provides database and informatics experts, customer service, expert advice, information products, and web technology to VA researchers and others.
Day, J. P.
This guide aims to instruct the CDS database administrator in: o The CDS file system. o The CDS index files. o The procedure for assimilating a new CDS tape into the database. It is assumed that the administrator has read SUN/79.
The article presents an attempt of description of Lean Administration concept. The pre- requisites and principles of Lean Administration system is given. Next, the functions and perspectives of “lean” activities are discussed together with methodological framework. The steps and auxiliary methods are also defined.
Written in a cookbook format with practical recipes this book helps you to perform various administrative tasks using Webmin and enables you to perform common jobs more efficiently.This book is perfect for System administrators who want to learn more advanced concepts of Webmin and how it can help to set up a server for development, testing or deployment.
P. Williamson, Ian; Enemark, Stig; Wallace, Judy;
This paper introduces basic land administration theory and highlights four key concepts that are fundamental to understanding modern land administration systems. Readers may recall the first part of the paper in October issue of Coordinates. Here is the concluding part that focuses on the changing...
Discussion of the trends towards more uses of postmodern analysis within the discipline of public administration, particularly in the USA......Discussion of the trends towards more uses of postmodern analysis within the discipline of public administration, particularly in the USA...
If you are a Linux administrator who is looking to gain knowledge that differentiates yourself from the crowd, then this is the book for you. Beginners who have a keen interest to learn more about Linux administration will also progress quickly with this resourceful learning guide.
Bergen, J. J., Ed.
This collection of papers focuses on school administration and its relation to students. It is contended that toay's student matures earlier; has higher expectations; is more affluent; is more isolated from adults; is more critical and outspoken; and, therefore, must be heard by teachers and administrators. A related document is EA 001578.…
Oral treatment with cytotoxic agents is to be preferred as this administration route is convenient to patients, reduces administration costs and facilitates the use of more chronic treatment regimens. For the taxanes paclitaxel and docetaxel, however, low oral bioavailability has limited development
Becker, Kirk A.; Bergstrom, Betty A.
The need for increased exam security, improved test formats, more flexible scheduling, better measurement, and more efficient administrative processes has caused testing agencies to consider converting the administration of their exams from paper-and-pencil to computer-based testing (CBT). Many decisions must be made in order to provide an optimal…
ADMINISTRATIVE CIRCULAR NO. 23 (REV. 2) – SPECIAL WORKING HOURS Administrative Circular No. 23 (Rev. 2) entitled "Special working hours", approved following discussion in the Standing Concertation Committee meeting of 9 December 2008, will be available on the intranet site of the Human Resources Department as from 19 December 2008: http://cern.ch/hr-docs/admincirc/admincirc.asp It cancels and replaces Administrative Circular No. 23 (Rev. 1) entitled "Stand-by duty" of April 1988. A "Frequently Asked Questions" information document on special working hours will also be available on this site. Paper copies of this circular will shortly be available in departmental secretariats. Human Resources Department Tel. 78003
ADMINISTRATIVE CIRCULAR NO. 23 (REV. 2) – SPECIAL WORKING HOURS Administrative Circular No. 23 (Rev. 2) entitled "Special working hours", approved following discussion in the Standing Concertation Committee on 9 December 2008, will be available on the intranet site of the Human Resources Department as from 19 December 2008: http://cern.ch/hr-docs/admincirc/admincirc.asp It cancels and replaces Administrative Circular No. 23 (Rev. 1) entitled "Stand-by duty" of April 1988. A "Frequently Asked Questions" information document on special working hours will also be available on this site. Paper copies of this circular will shortly be available in Departmental Secretariats. Human Resources Department Tel. 78003
We can all be Linux experts, provided we invest the time in learning the craft of Linux administration. Pro Linux System Administration makes it easy for small to medium--sized businesses to enter the world of zero--cost software running on Linux and covers all the distros you might want to use, including Red Hat, Ubuntu, Debian, and CentOS. Authors, and systems infrastructure experts James Turnbull, Peter Lieverdink, and Dennis Matotek take a layered, component--based approach to open source business systems, while training system administrators as the builders of business infrastructure. If
argued that the changes in administrative practices during the last decade constitute a transformation, but also a reproduction of relations between knowledge and governing that goes back to the big expansion of the welfare state. Second, it is argued that these relations between knowledge and governing...... are not restricted to the administrative practices, but are part of education and its humanistic legacy as well. As such, the administrative demand of documentation becomes possible and recognisable through its reproductive elements. Elements that are constituted in a transformative conjunction in...
... 04/30/2016) New CDC Autism Data Highlights Importance of Long-term Services and Supports, Cultural Competency ( ... STAY CONNECTED Facebook Twitter YouTube E-mail Updates Administration for Community Living • Washington, DC 20201 Last Modified: ...
P. Williamson, Ian; Enemark, Stig; Wallace, Judy;
This paper introduces basic land administration theory and highlights four key concepts that are fundamental to understanding modern land administration systems - firstly the land management paradigm and its influence on the land administration framework, secondly the role that the cadastre plays...... in contributing to sustainable development, thirdly the changing nature of ownership and the role of land markets, and lastly a land management vision that promotes land administration in support of sustainable development and spatial enablement of society. We present here the first part of the paper. The second...... part focuses on the changing role of ownership and the role of land markets, and a land management vision will be published in November issue of Coordinates. Udgivelsesdato: Oktober...
Social Security Administration — The purpose of this agreement is for SSA to verify SSNs and other identifying information for the Department of Veterans Affairs, VHA. DVA will use the information...
Article denouncing the supposed impartiality of signatories of a report released by the Union of Concerned Scientists (UCS), which accused the Bush administration of systemically suborning objective science to a political agenda (1 page).
Institute of Museum and Library Services — This dataset of administrative records contains discretionary grant recipients who were awarded funds by the Institute of Museum and Library Services from fiscal...
This article discusses education of system administration. Theoretical foundations cover psychology, learning theory, instruction theory, and instructional design, leading to an ideal progression for education, and related tools. The main part describes an existing class on system administration as given at the University of Applied Sciences (Fachhochschule, FH) Regensburg, Germany. It is analyzed for its history and target audience, the current curriculum, course layout, and for the didac...
A step-by-step guide to learn how to set up security on Linux servers by taking SELinux policies into your own hands.Linux administrators will enjoy the various SELinux features that this book covers and the approach used to guide the admin into understanding how SELinux works. The book assumes that you have basic knowledge in Linux administration, especially Linux permission and user management.
This dissertation deals with the topic of the corruption in a public administration. It is aimed at an identification of key corruption threats which are typical for a public administration, further at an analysis of the corruption causes and its forms, an identification of its developmental stages, including the analysis of current anti-corruption measures and drafts to an optimal answer within the Czech Republic. The theoretical part of this dissertation in its indroduction contents the ...
This book is a practical, hands-on guide, taking the reader from the basics of using Cassandra though to the installation and the running.Learning Cassandra for Administrators is for administrators who manage a large deployment of Cassandra clusters, and support engineers who would like to install the monitoring tools and who are also in charge of making sure the cluster stays the same, ensuring that the service is always up and running.
M .R. Sindhu; Viraj M. Jamle; Pramod M. Shelke; Shrikant G. Baheti
The basic and universal corner stone of good governance are quality of service, quick response mechanisms and above all accountable and transparent process mechanism. The active city administration initiatives resulted in computerization of the legacy systems in government with limited ability to internalize the advances in information and communication technologies.By using active city administration services we able to know real time, quantitative and basic approach of the government servic...
G. E. Gale
Full Text Available All scientific work must be carried out against a background of adequate administrative support if it is to become effective and produce useful results. Administration is not a job for which we, as scientists, are particularly trained; and it is a thing of which we tend to fight shy, partly because, author suppose, most Of peoples are associate the administrator with highly unpleasant matters such as income tax, delays in getting our pay cheques, and so on - For that reason we do not feel, always pay sufficient attention to administrative affairs ; rather like the ostrich, we try to escape from them by merely ignoring them. But that is a wrong and unfruitful attitude to adopt. All live so much under the activities of the trained administrator that should, if, it give a great deal of thought to our own administrative problems deliberate and conscious thought to them-and make an honest and heart-searching self analysis regarding our own possible failings.
朱宏刚; 韩明; 龚仁杰; 姚兵; 邱劲; 胡波勇; 王瑜; 刘庆; 余晓晖
Objective To investigate the clinical efficacy of transurethral holmium laser combined with intravesical instillation of gemcitabine in treatment of cystitis glandularis .Methods Based on biopsy and cystoscopy ,52 cases of patients were diagnosed as cystitis glandularis .With the agreement of families ,all patients were treated with this type of surgery .Results The all patients were fol-lowed up for 6 to 36 months.Among them,33 cases were cured and 8 cases improved.There were 4 cases with recurrence during 6 to 12 months ,but not becoming cancerous .Conclusion Transurethral holmium laser resection combined with postoperative intravesical gem-citabine therapy can effectively reduce the recurrence of glandular cystitis with fewer side -effects and more safety .%目的：探讨经尿道钬激光联合吉西他滨灌注治疗腺性膀胱炎（ cystitis glandularis ，CG）的疗效。方法52例CG患者经活组织检查、膀胱镜检等方法确诊后，均行经尿道钬激光切除，术后采取吉西他滨膀胱灌注化疗进行治疗。结果52例患者获得6～36个月随访，33例治愈，8例好转，4例6～12个月复发，均未发生癌变。结论经尿道钬激光切除联合术后吉西他滨膀胱内灌注治疗CG术后复发率低，并发症少，安全性高。
Grimmelikhuijsen, Stephan; Jilke, Sebastian; Olsen, Asmus Leth; Tummers, Lars
We propose behavioral public administration as a designated subfield in public administration which explicitly deals with the integration of theories and methods from psychology into the study of public administration. We discuss how scholars in public administration currently draw on both methodological and theoretical innovations in psychology and point to research questions in public administration which could benefit from further integration. Behavioral public administration cannot, and s...
other words: Good governance and sustainable development is not attainable without sound land administration or - more broadly – sound land management. The paper presents a land management vision that incorporates the benefits of ICT enabled land administration functions. The idea is that spatial......Good governance is a qualitative term or an ideal which may be difficult to achieve. Different people, organisations, and government authorities will define “good governance” according to their own experience and interests. In any case, almost all kind of government includes a spatial component. In...... enabling of land administration systems managing tenure, valuation, planning, and development will allow the information generated by these activities to be much more useful. Also, the services available to private and public sectors and to community organisations should commensurably improve. Knowledge...
If you're an experienced system administrator looking to acquire Linux skills, or a seasoned Linux user facing a new challenge, Linux System Administration offers practical knowledge for managing a complete range of Linux systems and servers. The book summarizes the steps you need to build everything from standalone SOHO hubs, web servers, and LAN servers to load-balanced clusters and servers consolidated through virtualization. Along the way, you'll learn about all of the tools you need to set up and maintain these working environments. Linux is now a standard corporate platform with user
Archer, Charles J.; Megerian, Mark G.; Ratterman, Joseph D.; Smith, Brian E.
Computer hardware fault administration carried out in a parallel computer, where the parallel computer includes a plurality of compute nodes. The compute nodes are coupled for data communications by at least two independent data communications networks, where each data communications network includes data communications links connected to the compute nodes. Typical embodiments carry out hardware fault administration by identifying a location of a defective link in the first data communications network of the parallel computer and routing communications data around the defective link through the second data communications network of the parallel computer.
As time goes on, system administrators are presented with increasingly complicated challenges. In the early days, a team of engineers might have had to look after one or two systems. These days, one engineer can administer hundreds or thousands of systems. System administrators are gradually replacing their tools with more advanced and flexible ones. One of the choices is Python. Structurally, Python is a modern, high-level language with a very clean syntax. Python comes with many built-in libraries that can make automation tasks easier. It also has extensive set of third-party libraries and a
If you're familiar with JIRA for issue tracking, bug tracking, and other uses, you know it can sometimes be tricky to set up and manage. In this concise book, software toolsmith Matt Doar clarifies some of the more confusing aspects by answering difficult and frequently asked questions about JIRA administration. Practical JIRA Administration shows you how JIRA is intended to be used, making it an ideal supplement to the extensive documentation already available. The book's chapters are loosely connected, so you can go straight to the information that best serves your needs. Understand the di
... Reduction: Getting the Most From the U.S. Fire Administration’s Daily National Operations Brief PDF 127 KB There ... staff. Follow us: Twitter Facebook YouTube U.S. Fire Administration 16825 S. Seton Ave. , Emmitsburg , MD 21727 USA 800‑ ...
the Head of MSc programmes, the MSc coordinator as well as the administrative secretary. A student panel meets with the department twice in the first year: Early in February to sum up experience from the first semester and in early in June to sum up experience from the second semester. At semester...
The art of being persuasive involves use of selected persuasive techniques appropriate to the individual and situation. Persuasive techniques are powerful tools of communication and productivity. Effective use of persuasive techniques can provide motivation to others and can mobilize them toward action that you, as an administrator, desire. PMID:11962076
IT departments everywhere will be integrating Macs and Mac OS X into their IT infrastructure and this book will tell them how to do it. It will serve as an authoritative, useful and frequently referenced book on Mac OS X administration.
Grimmelikhuijsen, Stephan; Jilke, Sebastian; Olsen, Asmus Leth;
We propose behavioral public administration as a designated subfield in public administration which explicitly deals with the integration of theories and methods from psychology into the study of public administration. We discuss how scholars in public administration currently draw on both...... methodological and theoretical innovations in psychology and point to research questions in public administration which could benefit from further integration. Behavioral public administration cannot, and should not, replace ‘conventional’ public administration, but it is complementary to it. Importantly......, behavioral public administration represents a two-way street in which public administration scholars use theories and methods from psychology, and psychologists, in turn, learn from our setting of political-administrative contexts to refine their theories and methods. Finally, we propose four principals to...
Land administration systems are the operational tool for conceptualizing rights, restrictions and responsibilities (RRRs) in land. Each of the rights, restrictions and responsibilities encompasses a human rights dimension that relates to the overall national land policies and should be unfolded as...... more than just rhetoric. This paper attempts to analyse the aspects of human rights in relation to land administration systems with a special focus on developing countries struggling to build adequate systems for governing the rights, restrictions and responsibilities in land. Human rights are the...... of being alive. Of special interest in relation to land and property is the right to own things and the right of food and adequate housing for all. More generally, human rights should be seen as an ethical responsibility of government to ensure that people enjoy some basic rights as human beings...
Lee, Christopher Jon; The ATLAS collaboration; Bogdanchikov, Alexander; Ballestrero, Sergio; Contescu, Alexandru Cristian; Dubrov, Sergei; Fazio, Daniel; Korol, Aleksandr; Scannicchio, Diana; Twomey, Matthew Shaun; Voronkov, Artem
The ATLAS Trigger and Data Acquisition (TDAQ) system is responsible for the online processing of live data, streaming from the ATLAS experiment at the Large Hadron Collider (LHC) at CERN. The online farm is composed of ̃3000 servers, processing the data readout from ̃100 million detector channels through multiple trigger levels. During the two years of the first Long Shutdown (LS1) there has been a tremendous amount of work done by the ATLAS TDAQ System Administrators, implementing numerous new software applications, upgrading the OS and the hardware, changing some design philosophies and exploiting the High Level Trigger farm with different purposes. During the data taking only critical security updates are applied and broken hardware is replaced to ensure a stable operational environment. The LS1 provided an excellent opportunity to look into new technologies and applications that would help to improve and streamline the daily tasks of not only the System Administrators, but also of the scientists who wil...
@@ The long-anticipated anti-monopoly law needs to better address the crucial distinction between administrative and economic monopolies The first five months of 2oo6 saw a surge in the profits achieved by key State enterprises, especially in the eight sectors including petroleum, telecommunication and electricity, which achieved 285 billion yuan (US$36 billion) in profits, accounting for about 86 percent of the total, according to a July report. From the Stateowned Assets Supervision and Administration Commission of the State (SASAC). This news was both heartening and disquieting, for the most profitable sectors happen to be monopolistic enterprises, mostly upstream the production chain, who achieve their profitability at the expense of those companies further downstream. For years these sectors have been at the centre of the "bust-the-trust" storm.
Murphy, Niall Richard
This essential guide explains what works, what doesn't, and most of all, what's practical about IPv6--the next-generation Internet standard. A must-have for network administrators everywhere looking to fix their network's scalability and management problems. Also covers other IPv6 benefits, such as routing, integrated auto-configuration, quality-of-services (QoS), enhanced mobility, and end-to-end security.
Security of tenure is widely considered to be the missing piece of the puzzle when it comes to eradication of poverty. And, as explained in the previous issue of Geoinformatics, the European Union is now placing land rights at the heart of EU development policy. This article presents a way forwar...... in terms of building flexible and "fit-for-purpose" land administration systems in developing countries. This will ensure security of tenure for all and sustainable management of the use of land....
If you are an experienced system administrator and know how to manage servers and set up web environments but now want to explore Moodle, this book is perfect for you. You'll get to grips with the basics and learn to manage Moodle quickly, focusing on essential tasks. Having prior knowledge of virtual learning environments would be beneficial, but is not mandatory to make the most of this book.
Myskin, Y. I.
The history of formation and development of tax administration is studied. The stages of genesis of tax administration are identified and described. The historically caused major trends in tax administration which are based on knowledge of the nature of causality are formulated. Досліджено історію становлення та розвитку управління оподаткуванням. Визначено та охарактеризовано етапи генезису управління оподаткуванням. На основі пізнання природи причинно-наслідкових зв’язків сфо...
This chapter analyses recent developments in tax administration and best practice. The chapter begins by contextualizing tax administration through a discussion on the necessary separation between the operational tasks performed in tax administration and the more generic, but nevertheless crucial, issues of organization, strategy and internal management required in tax administration. The chapter then describes the recent genesis and the current context of tax administration - especially in E...
Fadil ZENDELI; Memet MEMETI; Agron RUSTEMI
Judicial control of administration and installation of courts as specialized institutions for resolving administrative disputes (conflicts) strengthened legitimacy, efficiency and accountability of the administrative bodies and this contributed to strengthening the protection of human rights against administrative bodies. The paper attempts to address the administrative disputes (conflict) in general hence giving specific data for some European countries and USA. Access to thesis topic is ana...
罗松涛; 王应洪; 李绪鲲; 柯井卫; 唐义权
Objective The objective of this study is to compare the effects of intravesical infusions of pirarubicin (THP) and mitomycin (MMC) on recurrence prevention and safety after transurethral resection of superficial bladder transient cell carcinoma. Methods Eighty seven patients with superficial bladder cancer were randomly divided into two groups, and were treated with intravesical infusions of THP or MMC after transurethral resection, respectively. Results Seven (17.1%) cases of recurrence were observed in THP group, with a mean 18.8-month follow-up. Ten (21.7%) cases of recurrence were observed in MMC group, with a mean 19.4-month follow-up. The hazard ratio (HR) for recurrence of two groups was 0.71 (95% confidence interval, 0.27 to 1.84,P = 0.48). In THP group,the incidence of localized and systematic side effects was 41.5% (17/41) and 7.3% (3/41), respectively. In MMC group, the incidence of localized and systematic side effects was 40.0% (17/46) and 8.7% (4/46), respectively. There was no statistics difference in localized and systematic side effects between the two groups (P > 0.05). Conclusion No differences were observed on the effects of recurrence prevention and safety of intravesical infusions of pirarubicin and mitomycin after transurethral resection of superficial bladder transient cell carcinoma.%目的:比较吡柔比星与丝裂霉素膀胱灌注对预防浅表性膀胱移行细胞癌术后复发的疗效与副反应.方法:根据随机数字表87例浅表性膀胱癌术后的患者,随机分成两组,分别用吡柔比星和丝裂霉素作膀胱灌注化疗,灌注化疗期间行血常规、肝肾功能检查.定期随访行膀胱镜或B超观评价肿瘤复发时间.结果:吡柔比星组41例,平均随访18.8个月,7例(17.1％)复发,丝裂霉素组46例,平均随访时间19.4个月,10例(21.7％)复发.两组患者随访期间复发风险比较Hazard Ratio(HR)=0.71(95％CI:0.27～ 1.84,P=0.48)；吡柔比星组局部副反应发生率为41.5％(17
The AS-DB and AS-SU groups within the Administrative Support division now offer a central entry point to the computer based Information Services under their responsibilities: the AIS Web site at http://ais.cern.ch.It features comprehensive search and navigation facilities as well as an activity based business map to guide AIS users to the information they want. Users will be able to launch any AIS WEB application from its desktop.Enjoy a visit of the site, we value your feedback at firstname.lastname@example.org!AS-DB/AS-SU
The article elaborates weather UML, primarily used in software engineering, can be a useful tool in business modeling and administration. By analyzing the advantages the modeling language has to offer we find that UML is visual and object oriented and that it is useful in expressing structure, interaction and behavior as well. With its help managers and business people can build models and diagrams to help put things into perspective. “Case Study 1” shows UML can be used as an analysis tool i...
Edge, Charles; Hunter, Beau
Charles Edge, Zack Smith, and Beau Hunter provide detailed explanations of the technology required for large-scale Mac OS X deployments and show you how to integrate it with other operating systems and applications. Enterprise Mac Administrator's Guide addresses the growing size and spread of Mac OS X deployments in corporations and institutions worldwide. In some cases, this is due to the growth of traditional Mac environments, but for the most part it has to do with "switcher" campaigns, where Windows and/or Linux environments are migrating to Mac OS X. However, there is a steep cu
黄维; 刘励; 陈光勇; 龚丽媛; 冯颖慧
目的 探讨前列腺突入膀胱距离(intravesical prostatic protrusion,IPP)及逼尿肌厚度(destrusor wall thickness,DWT)与良性前列腺增生(benign prostatic hyperplasia,BPH)所致膀胱出口梗阻(bladder outlet obstruction,BOO)的关系,旨在寻找一种简单、非侵入性诊断的方法.方法 选择前列腺增生有下尿路症状患者200例,予经腹超声检查及尿流动力学检查,测量参数包括:IPP、DWT、残余尿量(post-void residual urine,PVR)、前列腺体积(prostate volume,PV)、尿流动力学Schaefer分级；对数据进行统计分析并绘制相应ROC曲线.结果 IPP、DWT、PV与Schaefer分级相关[相关系数(r)分别为0.73、0.56、0.23,P值均＜0.01]；PVR与Schaefer分级无关；IPP、DWT、PV的ROC曲线下面积分别为0.80、0.84、0.60.结论 经腹超声测量DWT、IPP可以预测前列腺增生患者BOO程度,是一种简单、无创、有效的评估方法.%Objective To investigate the correlation of intravesical prostatic protrusion (IPP) and detrusor wall thickness (DWT) with bladder outlet obstruction (BOO) in patients with benign prostatic hyperpla-sia ( BPH) ,and to find a simple and noninvasive method to diagnose BOO. Methods A total of 200 men with lower urinary tract symptoms (LUTS) due to BPH were prospectively enrolled. The initial evaluation included DWT,IPP,post-void residual urine (PVR),prostate volume (PV) ,Schaefer obstruction class. These data were analyzed with statistic and produced a ROC curve. Results There are significant correlation between IPP,DWT and PV with the Schaefer obstruction class (r =0.73 ,0. 38,0. 23 ,respectively;P < 0.01). There were no correlation between PVR and the Schaefer obstruction class. The AUC for IPP,DWT,PV was 0. 80,0. 84,0. 60,respectively. Conclusion Trans-abdominal ultrasound of IPP and DWT can be used to predict patients with BOO due to BPD,and it is a simple,noninvasive,and effective method.
Wheelbarger, J. J.
From "achievement motivation" and "administration" to "Theory Z" and "viscidity and hedonic tone," this glossary defines 87 terms as they are used in educational administration. The terms include philosophical, psychological, organizational, and social concepts, but they all are employed in the theory and practice of administration. A short…
Full Text Available Judicial control of administration and installation of courts as specialized institutions for resolving administrative disputes (conflicts strengthened legitimacy, efficiency and accountability of the administrative bodies and this contributed to strengthening the protection of human rights against administrative bodies. The paper attempts to address the administrative disputes (conflict in general hence giving specific data for some European countries and USA. Access to thesis topic is analytical and contributes to the recognition of administrative disputes as legal and functional mechanism in building the rule of law. The paper will result with appropriate conclusions that reflect the work of institutions and administrative disputes (conflict itself as a legal instrument and will help the concerned parties, officials, judges, researchers for theoretical and practical importance of administrative disputes (conflict.
Abbott, Max G.; Eidell, Terry L.
The director of the Center for the Advanced Study of Educational Administration at the University of Oregon and one of his associates discuss the new role of administration in an individual-oriented educational system. (AA)
Evan, William M.
Considered are some trends in American administrative law, some trends in organization theory, a model of the administrative process, and several potentially useful research strategies. The analysis has implications for comparative research on legal systems. (Author/LBH)
The theoretical basis and essence of some common and specific functions of land administration system as an integral mechanism of effective land use and land administration levels (case-study for forest and other land available for afforestation) are analysed.
Social Security Administration — CCMA is the server that provides a browser-based tool for contact center administrators and supervisors. It is used to manage and configure contact center resources...
Anderson, Joyce S.
Argues that theories of management and administration should be put into practice in the same academic institutions in which they were born, as they have the same applicability for college administrators as corporate managers. (DMM)
The subject of the thesis is the legal definition of the proceedings for minor offence which falls within the area of administrative punishment on the issue of pardon of the oral proceedings on the part of the accused and the tutoring of the administrative authorities. Proceedings for minor offences is governed by the administrative regulations and the law the on misdemeanors. The administrative authorities must follow the basic principles of its activities which does not stem only from these...
Bird, Richard M.
The best tax policy in the world is worth little if it cannot be implemented effectively. Tax policy design in developing countries must therefore take the administrative dimension of taxation carefully into account. What can be done may to a considerable extent determine what is done in any country. This paper discusses the relationship between tax policy and tax administration. When can policy lead administration? When must policy initiatives wait on administrative reform? How exactly can b...
This paper attempts to identify the standards to which EU candidate countries are expected to conform in order to align their public administrations with those of EU Member States. Originating from SIGMA’s work on public administration reform in central and eastern European countries, in particular civil service development and administrative control, the paper describes an important part of the basis of the SIGMA methodology for assessing candidate countries’ public administration capacities...
Full Text Available The article analyzes the principles of interpretation for administrative contracts, in French law and in Romanian law. In the article are highlighted derogations from the rules of contract interpretation in common law. Are examined the exceptions to the principle of good faith, the principle of common intention (willingness of the parties, the principle of good administration, the principle of extensive interpretation of the administrative contract. The article highlights the importance and role of the interpretation in administrative contracts.
Knight, William E.; Folkins, John W.; Hakel, Milton D.; Kennell, Richard P.
Do academic administrators make decisions about resource allocation differently depending on the discipline receiving the funding? Does an administrator's academic identity influence these decisions? This study explored those questions with a sample of 1,690 academic administrators at doctoral-research universities. Participants used fictional…
Full Text Available The article elaborates weather UML, primarily used in software engineering, can be a useful tool in business modeling and administration. By analyzing the advantages the modeling language has to offer we find that UML is visual and object oriented and that it is useful in expressing structure, interaction and behavior as well. With its help managers and business people can build models and diagrams to help put things into perspective. “Case Study 1” shows UML can be used as an analysis tool in business modeling to help increase the complexity and depth of the event or project that is being developed. “Case Study 2” attempts to prove that UML can also be efficiently used in finding solutions to newly appeared problems in a business environment. Despite the practicality of the Unified Modeling Language there is still some criticism brought to it. Some programmers consider it to be hard to learn and some developers claim that it is too abstract. The article concludes that despite the minor drawbacks; due to its adaptability and complex visual models, it is a very useful tool that adds value to the modeling of business structures and processes.
Full Text Available The Romanian legislation, meaning by this Law no. 554/2004, creates in article no. 5 a special regime for some administrative acts which will be considered as exceptions from the “common administrative procedure”. These acts are not subject to the review of the courts, the exception being a total one or a partial one as it will be described in this study. The existence of the administrative procedure does not mean an absolute control on the administration. This is in fact the main reason why this article was included in Law no. 554/2004 and all implications will be described in this study.
Marta – Claudia CLIZA
Full Text Available The Romanian legislation, meaning by this Law no. 554/2004, creates in article no. 5 a special regime for some administrative acts which will be considered as exceptions from the „common administrative procedure”. These acts are not subject to the review of the courts, the exception being a total one or a partial one as it will be described in this study. The existence of the administrative procedure does not mean an absolute control on the administration. This is in fact the main reason why this article was included in Law no. 554/2004 and all implications will be described in this study.
The Romanian legislation, meaning by this Law no. 554/2004, creates in article no. 5 a special regime for some administrative acts which will be considered as exceptions from the „common administrative procedure”. These acts are not subject to the review of the courts, the exception being a total one or a partial one as it will be described in this study. The existence of the administrative procedure does not mean an absolute control on the administration. This is in fact the main reason why ...
My final thesis is dedicated to information systems in public administration, focused on one of the key information systems for the area of authority punishment within the competence of Customs Administration of the Czech Republic. On this information system there can be clearly qualitatively described essential elements affecting not just the creation and development but mainly the future growth and importance of it self within other systems of customs administration. This thesis is also d...
This study serves as an introduction to how virtual reality systems could be applied in public administration and what research tasks would be necessary to accomplish a project. E-government solutions began to emerge in public administration approximately a decade ago all over the developed world. Administration service facilities via the Internet did not attract many customers, because of the digital divide. E-government solutions were extended to mobile devices as well, but the expected bre...
Demaris, Michalyn C.; Kritsonis, William Allan
Postmodernism has many inferences that can be applied to the theory and practice of higher educational administration. Today, in higher education administrators are continuously focused on strategies that will ensure the future of minority educational institutions. As a result postmodernism is an important factor in the future of higher…
Utah State Office of Education, Salt Lake City.
Recognizing the importance of efficient and effective program administration for the success of Utah's Child Nutrition Programs, the State Office of Education developed a manual to assist local program administrators in using the U.S. Department of Agriculture's (USDA's) programs. This document contains Part 1 of the manual's four interrelated…
Dunbar, Roger L. M.
A study of 65 articles from the 1981 volumes of "Administrative Science Quarterly" and "Harvard Business Review," using smallest space analysis, found that the few studies adopting subjective (instead of objective) approaches to analyzing organizational change were most likely to provide a basis for an applied administrative science. (Author/RW)
Writers attempting to describe administration have approached the subject from a number of perspectives. Researchers such as Gulick (1937) identified planning, organizing, staffing, directing, coordinating, reporting, and budgeting as functional elements of administration. Hemphill, Griffiths, and Fredericksen (1962), using simulated job settings,…
Covel, Janice; Ortiz, Flora Ida
From 1870 to 1975, three types of school administrators were identified: the plateau administrators who remained at initial entry level assignments; vertical aspirants who actively sought advancement; and place-holders who began as vertical aspirants but for one reason or another were placed in non-decision-making positions. (Author/GDC)
Full Text Available This study serves as an introduction to how virtual reality systems could be applied in public administration and what research tasks would be necessary to accomplish a project. E-government solutions began to emerge in public administration approximately a decade ago all over the developed world. Administration service facilities via the Internet did not attract many customers, because of the digital divide. E-government solutions were extended to mobile devices as well, but the expected breakthrough of usage has not ensued. The virtual reality form of public administration services recommended in this study has the most attractive outlay and the simplest navigation tools if compared to ‘traditional’ Internet based e-government. Thus, in accordance with the worldwide amazingly quick spread of the virtual reality systems of Second Life and 3 D types of entertainment, virtual reality applications in public administration could rely on a wide range of acceptance as well.
Full Text Available One of the variables that affects success in business life is emotional intelligence of working people. The purpose of this research is to identify whether the school administrators’ emotional intelligence scores differ meaningfully according to their gender, marital status, branch, being a principal or assistant principal, being elementary school administrator or high school administrator, having manegerial education course or not, educational background, period of occupational service, age, length of administration service, number of children. 180 administrators working as a principals and vise principals who worked in 2005 in Düzce elementary schools and high schools were surveyed in line with this aim. Mann-Whitney U-test, Kruskal Wallis test and ANOVA were used in order to find out groups that differ from others. It has been found that school administrators’ emotional intelligence scores differ meaningfully in terms of administrators’ branch and being elementary school administrator or high school.
Mansour Haghighatian; Somayeh Karimizadeh; Javad Nazari
Introduction Administrative corruption is a complicated and multi-faceted phenomenon that has many causes and ramifications, which manifest themselves in different forms in various countries and appear to be endemic of all social systems where authority is delegated. Although there might be different definitions of and approaches towards administrative corruption, the definition that has been put forward by the World Bank and Transparency International appears to be more general and compreh...
Hansen, H. S.; Skov-Petersen, H.
Rapporten indeholder dels en beskrivelse af de vigtigste nationale databaser med stedfæstet information og dels en vejledning i sammenstilling imellem digitale kort og administrative registre. Rapportens første del beskriver de enkelte databaser med hensyn til bl.a. adgangsforhold, indhold og...... nøgler, hvoraf sidstnævnte spiller en afgørende rolle i forbindelse med sammenstilling af digitale kort og administrative registre. Rapportens anden del fokuserer på praktiske forsøg med sammenstilling af digitale kort og administrative register. Der gives anvisninger på sammenstilling af Bygnings- og...
Andrews, M M
Population demographics are reshaping the healthcare work force with respect to race, ethnicity, gender, national origin, sexual orientation, age, handicap, disability, and related factors as national sensitivity to various forms of diversity grows. Given the demographic trends, it is inevitable that nurse administrators will need skill in transcultural administration as they manage diversity and identify the cultural origins of conflict in the multicultural workplace. Culture influences the manner in which administrators, staff and patients perceive, identify, define and solve problems. In this article, the complex and interrelated factors that influence workplace diversity are examined. PMID:9824983
Department of Homeland Security — The U.S. Fire Administration collects data from a variety of sources to provide information and analyses on the status and scope of the fire problem in the United...
U.S. Environmental Protection Agency — Case and Administrative Support Tools (CAST) is the secure portion of the Office of General Counsel (OGC) Dashboard business process automation tool used to help...
Department of Housing and Urban Development — This site contains substantive and precedential decisions issued by the Office of Administrative Law Judges. The site does not contain subsequent rulings or...
Lemmen, C.; Van Oosterom, P.J.M.; Bennett, R.
Societal drivers including poverty eradication, gender equality, indigenous recognition, adequate housing, sustainable agriculture, food security, climate change response, and good governance, influence contemporary land administration design. Equally, the opportunities provided by technological dev
Minnesota Department of Natural Resources — DNR land ownership and administrative interest mapped to the PLS forty level. This layer merges the DNR Control Point Generated PLS layer with IBM mainframe-based...
Minnesota Department of Natural Resources — DNR land ownership and administrative interest mapped to the PLS forty level. This layer merges the DNR Control Point Generated PLS layer with IBM mainframe-based...
Minnesota Department of Natural Resources — DNR land ownership and administrative interest mapped to the PLS forty level. This layer merges the DNR Control Point Generated PLS layer with IBM mainframe-based...
U.S. Department of Health & Human Services — The Centers for Medicare and Medicaid Services (CMS) has compiled a summary of overall Medicare Administrative Contractor (MAC) performance information as measured...
In this study, the impacts of modernism and postmodernism on public administration have been comperatively examined. This distinction between modernism and postmodernism also expresses different living and thinking ways in point of perceiving and giving meaning to social life. This situation naturally denotes in the field of administration. While bureaucratic organisations become experienced modernism, post-bureaucratic organisations reflect postmodern life in a way that postmodernism rejects...
Montesinos López, Anna Isabel
This paper deals with terminology teaching in the administration field in Catalan language in the context of the specialisation subjects that are offered in the Public Administration Management Degree of the Universitat Politècnica de València (Polytechnic University of Valencia). In this sense, we start from the idea that in order to develop a good system for the teaching of terminological units, previous descriptive studies are required regarding the lexical and specialised combina...
Enemark, Stig; Williamson, I
Capacity building increasingly seen as a key component of land administration projects in developing and countries in transition undertaken by the international development banks and individual country development assistance agencies. However, the capacity building concept is often used within a...... should be dealt with as capacity building projects in themselves. The article introduces a conceptual analytical framework that provides some guidance when dealing with capacity building for land administration in support of a broader land policy agenda....
Mulligan, Deirdre; Bamberger, Kenneth a.
Administrative agencies increasingly rely on technology to achieve substantive goals. Often this technology is employed to collect, exchange, manipulate and store personally identifiable information, raising serious concerns about the erosion of personal privacy. Congress has recognized this problem. In the E-Government Act of 2002, it required administrative agencies to conduct privacy impact assessments (PIAs) when developing or procuring technology systems that handle personal inf...
If you are a database administrator who needs to get to grips with PostgreSQL quickly and efficiently, then this book is for you. This book will also be highly beneficial if you are a project leader or a developer who is interested in knowing more about database systems or bottleneck detection, as it will enable you to work more closely and cooperatively with your administrators.
E S Nwauche
Full Text Available This article reviews the interpretation of section 6(2(aii of the Promotion of Administrative Justice Act which makes an administrator “biased or reasonably suspected of bias” a ground of judicial review. In this regard, the paper reviews the determination of administrative bias in South Africa especially highlighting the concept of institutional bias. The paper notes that inspite of the formulation of the bias ground of review the test for administrative bias is the reasonable apprehension test laid down in the case of President of South Africa v South African Rugby Football Union(2 which on close examination is not the same thing. Accordingly the paper urges an alternative interpretation that is based on the reasonable suspicion test enunciated in BTR Industries South Africa (Pty Ltd v Metal and Allied Workers Union and R v Roberts. Within this context, the paper constructs a model for interpreting the bias ground of review that combines the reasonable suspicion test as interpreted in BTR Industries and R v Roberts, the possibility of the waiver of administrative bias, the curative mechanism of administrative appeal as well as some level of judicial review exemplified by the jurisprudence of article 6(1 of the European Convention of Human Rights, especially in the light of the contemplation of the South African Magistrate Court as a jurisdictional route of judicial review.
Lalić Nataša Z.
Full Text Available Giving consideration to punishment, one of the inevitable elements of school discipline, always reactivates the issue of punishment administration and its effects in school setting. Punishment is administered by a beforehand-determined intention, its general and final goal being the attempt to make a child change his/her behavior so as to more successfully take part in school life. The issue of how much it is justifiable to administer punishment, as a way of directing child’s behavior, is not only raised in professional discussions but occurs as a personal dilemma with parents, teachers and all those involved in child upbringing. The definition of punishment contains certain incompatible elements in attitudes, which is reflected in punishment administration within different social contexts. Based on the analysis of research results, the paper discusses all the elements the teacher should be well acquainted with, influencing the effectiveness of punishment. The effects of punishment administration depend, among other things, on the type of punishment, way in which a person experiences and perceives punishment and the way of administering it. Prior to punishment administration, as a means of directing child’s behavior factors influencing successfulness of punishment should be established consistency in punishment administration, postponement of punishment intensity of punishment, explanation for punishment administration, nature of interrelations between a child and a person punishing him/her.
... 45 Public Welfare 1 2010-10-01 2010-10-01 false Contract administration. 74.47 Section 74.47 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION UNIFORM ADMINISTRATIVE... administration. A system for contract administration shall be maintained to ensure contractor conformance...
... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Administration. 831.101 Section 831.101 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT Administration and General Provisions § 831.101 Administration. (a) OPM has charge of...
... 7 Agriculture 3 2010-01-01 2010-01-01 false Administration. 56.3 Section 56.3 Agriculture... EGGS Grading of Shell Eggs General § 56.3 Administration. The Administrator shall perform, for and... administration of the provisions of the Act and the regulations in this part. The Administrator is authorized...
Kalytych, G.; Litosh, G.
The article analyses the approaches to the notions of "information", "state administration system", "administrative information". The article considers the importance of of information for the whole state administration system and reveals the criteria which provide the information with administrative status. Special attention is paid to making of administrative decisions on the level of the sate which are based on effective information management.
... HUMAN SERVICES Administration for Children and Families Administration for Native Americans AGENCY: Administration for Native Americans, ACF, HHS. ACTION: Notice to Award Five Urgent Single-Source Grants. CFDA... Administration for Children and Families (ACF), Administration for Native Americans (ANA) has awarded five...
... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Administrator. 702.170-2... DEFINITIONS OF WORDS AND TERMS Definitions 702.170-2 Administrator. Administrator means the Administrator or Deputy Administrator of the U.S. Agency for International Development....
... 7 Agriculture 9 2010-01-01 2009-01-01 true Market administrator. 1000.25 Section 1000.25... Rules of Practice and Procedure Governing Market Administrators § 1000.25 Market administrator. (a) Designation. The agency for the administration of the order shall be a market administrator selected by...
... 7 Agriculture 11 2010-01-01 2010-01-01 false Deputy Administrator. 1700.26 Section 1700.26... AGRICULTURE GENERAL INFORMATION Agency Organization and Functions § 1700.26 Deputy Administrator. The Deputy Administrator aids and assists the Administrator. The Deputy Administrator provides overall policy direction...
Cornell, Agnes; Lapuente, Victor
This paper presents a hypothesis for understanding democratic stability based on the distinction between politicized and meritocratic bureaucracies. We argue that in a politicized administration, the professional careers of large numbers of government officials depend directly upon which party wins....... Conversely, in democracies with meritocratic administrations, incumbents are credibly constrained from undertaking partial policies because their hands are tied in terms of managing the staff policy of the state apparatus. Consequently, countries with meritocratic bureaucracies have greater prospects for...... democratic stability. Empirically, we illustrate the mechanisms with two well-documented cases of democratic transitions that enshrined a politicized administration – Spain (1876–1936) and Venezuela (1958–1998) – and one transition that kept a meritocratic bureaucracy, Spain (1975–)....
Knutson, B.J., Westinghouse Hanford
This document is a guide for use by the Tank Waste Remediation System (TWRS) Information Locator Database (ILD) System Administrator. The TWRS ILD System is an inventory of information used in the TWRS Systems Engineering process to represent the TWRS Technical Baseline. The inventory is maintained in the form of a relational database developed in Paradox 4.5.
Knight, Brian; Snyder, Wayne; Armand, Jean-Claude; LoForte, Ross; Ji, Haidong
SQL Server 2005 is the largest leap forward for SQL Server since its inception. With this update comes new features that will challenge even the most experienced SQL Server DBAs. Written by a team of some of the best SQL Server experts in the industry, this comprehensive tutorial shows you how to navigate the vastly changed landscape of the SQL Server administration. Drawing on their own first-hand experiences to offer you best practices, unique tips and tricks, and useful workarounds, the authors help you handle even the most difficult SQL Server 2005 administration issues, including blockin
The importance of strict administrative procedures in the daily work is being demonstrated by commenting on events that occured in the operation of German nuclear power plants. The procedure for working in an area of the plant (pressurized medium, high-radioactive level, explosive of flammable mediums), where special measures for safe working have to be taken, is discussed in detail. The administrative problems during refuelling time are further on mentioned, especially the problems connected with administering more than 1,000 people with respect to health protection and sabotage protection. Some general comments on the influences from external causes (authorities, courts, etc.) are given. (orig./ORU)
Beginning SQL Server 2008 Administration is essential for anyone wishing to learn about implementing and managing SQL Server 2008 database. From college students, to experienced database administrators from other platforms, to those already familiar with SQL Server and wanting to fill in some gaps of knowledge, this book will bring all readers up to speed on the enterprise platform Microsoft SQL Server 2008. * Clearly describes relational database concepts* Explains the SQL Server database engine and supporting tools* Shows various database maintenance scenarios What you'll learn* Understand c
... Employment and Training Administration Comment Request for Information Collection for Internal Fraud and...: Employment and Training Administration (ETA), Department of Labor. ACTION: Notice. SUMMARY: The Department of.... Currently, the Employment and Training Administration is soliciting comments concerning the Office...
... Federal Aviation Administration Notice of Intent To Rule on Request To Release Airport Property at the Dallas/Fort Worth International Airport, DFW Airport, Texas AGENCY: Federal Aviation Administration (FAA... Aviation Administration, Southwest Region, Airports Division, Texas Airports Development Office,...
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION Federal Highway Administration AGENCY: Federal Highway Administration (FHWA), DOT. ACTION: Notice of...: Federal Highway Administration, Kentucky Division: Mr. Greg Rawlings, Transportation Specialist, 330...
... Federal Aviation Administration Approval of Noise Compatibility Program for Kona International Airport at Keahole, Keahole, North Kona, HI AGENCY: Federal Aviation Administration, DOT. ACTION: Notice. SUMMARY: The Federal Aviation Administration (FAA) announces its findings on the noise compatibility...
... Federal Highway Administration Notice of Final Federal Agency Action on Proposed Transportation Project in Illinois and Indiana AGENCY: Federal Highway Administration (FHWA), DOT. ACTION: Notice of limitation on..., Federal Highway Administration, 3250 Executive Park Drive, Springfield, Illinois 62703, Phone: (217)...
... Federal Aviation Administration Notice of Availability of a Draft Environmental Assessment and Public...: Federal Aviation Administration (FAA), DOT. ACTION: Notice of Availability of a Draft Environmental... Chicago, Illinois. SUMMARY: The Federal Aviation Administration (FAA) proposes to fund, construct,...
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE International Trade Administration Antidumping or Countervailing Duty Order, Finding, or Suspended Investigation; Advance Notification of Sunset Reviews AGENCY: Import Administration, International Trade Administration, Department of Commerce....
Reza TAHMASEBI; Seyyed Mohammad Mahdi MUSAVI
The issue of politics-administration dichotomy as one of the five great issues in the field of public administration has had a strange history. For more than a century it has been one of the most disreputable notions in the field of public administration. At the heart of the public administration is the relationship between administrators, on one hand, and politicians and the public on the other hand. The nature of that relationship and the proper role of political leaders and administrators ...
Eye, Glen G.; and others
"Concerned with the spiraling problems of technology and its impact on instruction, the American Association of School Administrators (AASA) two years ago created the Committee on Technology and Instruction. Since that time the Committee has been active in investigating a number of areas relevant to the impact of technology on the public schools. …
The Contract Administrative Tracking System (CATS) was developed in response to an ORD NHEERL, Mid-Continent Ecology Division (MED)-recognized need for an automated tracking and retrieval system for Cost Reimbursable Level of Effort (CR/LOE) Contracts. CATS is an Oracle-based app...
Porter, Dennis R.
Key adult education management functions (planning, directing personnel, organizing work, staffing, and evaluating) can be enhanced through appropriate technologies. Of particular interest to administrators are computer-based communications, management information systems, and desktop application software such as spreadsheets, groupware, and…
The Atomic Act specifies, among other things, responsibilities of the government in the field of safe disposal of radioactive wastes. To satisfy this responsibility, the Ministry of Industry and Trade has established the Radioactive Waste Repositories Administration (SURAO). SURAO's major responsibilities include: (a) the preparation, construction, commissioning, operation, and decommissioning of radioactive waste repositories and the monitoring of their environmental impacts; (b) radioactive waste management; (c) spent or irradiated nuclear fuel processing into a form suitable for storage/disposal or reuse; (d) record-keeping of received radioactive wastes and their producers; (e) administration of fund transfers as stipulated by the Atomic Act, Article 27; (f) development of proposals for specification of fees to be paid to the Nuclear Account; (g) responsibility for and coordination of research and development in the field of radioactive waste handling and management; (h) supervision of licensees' margin earmarked for the decommissioning of their facilities; (i) providing services in radioactive waste handling and management; (j) handling and management of radioactive wastes that have been transferred to the Czech Republic from abroad and cannot be sent back; (k) interim administration of radioactive wastes that have become state property. The Statute of the Administration is reproduced in full. (P.A.)
Cutler, M. Rupert
RARE II is a new Roadless Area Review and Evaluation of the National Forest system. Administrators are attempting to inventory existing wilderness areas and to determine criteria for setting aside additional ones. This information will be used for the required 1980 update of the national assessment of forests and rangelands. (MA)
Engelschalk, Michael; Melhem, Samia; Weist, Dana
Computerization is an important part of World Bank tax and customs projects. Revenue administration computerization projects should be seen in the broader context of public sector reforms. They touch on issues such as the government's overall strategy for information technology, the revenue agency's autonomy in maintaining information technology systems, civil service laws and procurement ...
Joseph, M Lindell; Fowler, Debra
The evolving and complex practice environment calls for new mindsets among nurse leaders, academics, and nurse innovators to envision innovative ways to manage and optimize traditional tasks and processes in nursing administration. The purpose of this article is to present 3 case studies that used linear programming and simulation to innovate staffing enterprises, financial management of healthcare systems, and curricula development. PMID:26906516
Samir Gupta; Donn, Steven M.
Surfactant replacement therapy has been the mainstay of treatment for preterm infants with respiratory distress syndrome for more than twenty years. For the most part, surfactant is administered intratracheally, followed by mechanical ventilation. In recent years, the growing interest in noninvasive ventilation has led to novel approaches of administration. This paper will review these techniques and the associated clinical evidence.
Millenium Challenge Corporation — The Millennium Challenge Account-Philippines' (MCA-P) implementation of the Revenue Administration Reform Project (RARP) is expected to improve tax administration,...
... SERVICE, DEPARTMENT OF AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Administration of the Veterinary Medicine Loan Repayment Program § 3431.20 Administration. The VMLRP will be administered by...
With the continuous development of management methods, as the implementation means of administrative policy and social management ideal, the administrative contract has been widely accepted. Administrative areas contract to become the focus of people's attention. Administrative priority in administrative contract is to distinguish between private rights contract with the most critical characteristics of administrative contracts. But there are many problems of administrative priority in practice. In this paper, writer begins from the content of administrative priority and put forward myself proposals for the improvement of power supervision.
... Administration Federal Property Management Regulations; Administrative Wage Garnishment AGENCY: Office of the... amending the U.S. General Services Administration Property Management Regulation (GSPMR) to remove... telephone number. The Administrative Wage Garnishment Code of Federal Regulations (CFR) Parts affected...
Full Text Available Introduction Administrative corruption is a complicated and multi-faceted phenomenon that has many causes and ramifications, which manifest themselves in different forms in various countries and appear to be endemic of all social systems where authority is delegated. Although there might be different definitions of and approaches towards administrative corruption, the definition that has been put forward by the World Bank and Transparency International appears to be more general and comprehensive. It defines corruption as the abuse of public power, office, or resources by public or elected governmental officials for personal gain, e.g. by extortion, soliciting or offering bribes. Recent research findings indicate that organizational commitment and work satisfaction on the part of employees could be an effective antidote to administrative corruption. On the other hand, employee sense of equity and fairness also has been shown to be effective in enhancing organizational commitment. Last but not least, employee financial needs could play a significant part in their vulnerability to corruption. Therefore, the main aim of this paper is as follows: by utilizing the ideas of Selznick on organizational commitment, Merton's views on work satisfaction, Taylor's and Schwartz's ideas on financial needs, and Barnard's views on managerial capabilities, the relationships of these variables on administrative corruption were studied. The other purpose of the paper is to examine the effects of some other related variables like age, sex, level of education, job seniority, and marital status on administrative corruption. Material and Methods The research method was quantitative, data collection technique was survey, and the tool of data collection was questionnaire. The research population of the study consisted of all 44116 employees of public organizations of the city of Yazd. Using a stratified sampling technique, 16 administrative organizations
1. Fermes ou régies ? Le mode d’administration de ces établissements n’avait rien d’anodin. Il relevait à la fois de considérations morales et économiques. Morales car les autorités de l’époque hésitaient à se compromettre dans l’administration d’un jeu par lequel on remettait sa fortune aux coups du sort. Les États pontificaux par exemple préférèrent s’en remettre à des particuliers au début de l’établissement du loto, avant de faire régir la loterie directement pour le compte de la Curie à ...
Davis, Gabriella; Duff, Thomas
The IBM Lotus Sametime 8.5.2 Administration Guide uses a practical, no-nonsense approach to give you the essential information you need. Using realistic scenarios, you learn how to configure and maintain your environment to meet your needs and take advantage of the flexibility offered in Sametime 8.5.2. If you are responsible for installing and administering Sametime 8.5.2, then this book is for you. If you're completely new to Sametime administration, this book will serve as your roadmap. If you're making the jump from a prior version of Sametime, then you'll see how Sametime 8.5.2 differs an
... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Contract administration. 12.947 Section 12.947 Public Lands: Interior Office of the Secretary of the Interior ADMINISTRATIVE AND AUDIT... Requirements § 12.947 Contract administration. A system for contract administration shall be maintained...
... 45 Public Welfare 1 2010-10-01 2010-10-01 false Program administration. 152.6 Section 152.6 Public... CONDITION INSURANCE PLAN PROGRAM PCIP Program Administration § 152.6 Program administration. (a) General... nonprofit private entities. (b) Administration by State. A State (or its designated non-profit...
... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Contract administration. 1210.47 Section 1210.47 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION... § 1210.47 Contract administration. A system for contract administration shall be maintained to...
... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Administration. 1.71 Section 1.71 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE GENERAL PROCEDURES Administration of the Fair Credit Reporting Act § 1.71 Administration. The general administration of the...